Hi everyone!!

I had my surgery 2/19 and came home 2/27. I had stage one of three. Everything is going good. I changed my appliance twice in the hospital with the stoma nurse. Everything is going okay at home, except it's shrinking and swelling is going down and it's hard to measure sometimes. I worry if I'm getting the right fit. All seems well except the one side of the wafer by my belly button pokes up at times. I have had three lap surgeries and after I had my baby, my belly button is shaped oval , plus I have baby weight. Any suggestions to keep that part of the wafer down. Also, can the wafer turtleneck too much around the stoma. Mine seems to be looking like it's being engulfed by the wafer. Is that bad??

Thanks for all of your help

Beth

Beth
Call convatec on monday and ask them for a sampler kit. Tell them you want to try durahesive moldable wafers and closed end pouches and whatever else you think you need.
Do you have a good ET nurse. What about home health?
Do you have an edgepark catalog
call them monday 1-800-321-0591 ask for one
does your stoma protrude enough?
eat marshmallows before changing so it slows down and behaves, also you can ice it, it has no feeling.
Measure each time as it keeps shrinking.
You can turn it sideways and cut it off center to avoid the bellybuttonas long as you aren't leaking underneath the wafer, i wouldn't wait longer than 3-4 days before changing. that extra day could cause trouble.

Hi Holly, I knew you would help I do use the convatec durahesive moldable wafers. I have the edgepark catalog, and I do have a very good ET nurse. I think it protrudes enough, it seems like it turtlenecks a lot higher than the one I did in the hospital. I have good output. I changed it yesterday. It shrunk, so I'm between 1 1/8 and 1" slightly oval. So it was hard to do. I know I'm in a learning curve, but it's hard because I know you don't want too much skin around showing, and not overlap on the stoma. I guess I can't find the happy middle. It seemed so easy with the stoma specialist of course. Thanks for your help!!

Beth

Great on all counts. Are you using stomahesive paste?Just measure each time with the cardboard thingee. Cutting is a challenge, there is a tool to pre cut with.
www.stomico.com
480-753-9354
like a hole punch!
if edgepark has it your ins may cover it, there are other hole cutters that are less, our ins paid i think

Hi
I'm not using any paste, should I use it by the part of the wafer that lifts a little by my belly button? I'm not sure exactly what the paste does. Also, do you think the turtlenecking is okay if it my stoma protrudes just a little above it?
Thanks so much

Beth

It sounds like the fit is good. I think the turtleneck effect is good and doesn't require paste. The paste would go on the wafer around where you cut and seals it.
I am surprised they didn't send you home with it. Also, less is best. Wash with dial or ivory don't use anti bacterial soap or deodorant sopa/fragrance.
If you think you eed a prep pad make sure you get no sting
did they give you allcare remover wipes to get the flange off easier?
You will have it down to a science in no time. Once the size is stable.
Keep asking questions though so you don't have to go through anything for nothing!

Instead of the paste Holly mentions, I use Eakin seals. YOu can put the Eakin right against the stoma and then can leave more room in the wafer opening since the Eakin will help protect the skin. I find the Eakin with the convex moldable wafer a great combo for me (although with my advancing pregnancy I will have to switch to a flat wafer soon - I'll still be using the moldable one though)

Eakin seals are very costly so be sure to have convatec send some samples before you buy to see if you like them, I didn't and neither did Chris and I sent them to a member.

The hospital did send me home with some stomapaste. I found it in my bag. I had to change my wafer again today. My skin is so sore. I did put some of the paste where the wafer lifts. I'm going to call my stoma nurse on Monday. Thanks for everyone's advice!!

Beth

I have the same problem and when I notice it start to peel up i'll cut alittle of the wafer around the belly button to keep it from bending it funny. I also have coloplast paste strips that you can rip off a bit, flatten it a bit and stick it where it is peeling to re-adhere it so it doesn't continue to peel up. Hope this helps!

By the way, what brand of device are you using now?

changing appliance too much will take its toll on your skin, you could end up with fungal rash, it will itch and get raw easily,
make sure it's very clean and dry, chris used a hair dryer before putting it on, convatec will send a small mirrir in the sample kit so you can see under the stoma to make sure it fits good.

Hi Beth,

It sounds like you are doing really well and you've had some good advice. However I find that stoma paste isn't really that good to use with the moldable wafers, it interfere's with the adhesion. I really don't find it's necessary to use anything with the moldable wafers as they really do mold to every contour, but if you do need that extra help then the eakin seals or similar are probably best. The wafer can't turtleneck too much so don't worry about that.

I have the same problem as you with the tape lifing where it meets my main incision. I've been opened up 9 times so I have aquired an extra couple of "belly buttons". What I do is to position the wafer so that the corner sits over the dimple. If it starts to lift I will just secure it again with some tape (Hytape is good)

The other thing that I find helps to keep the wafer really secure is to wear really good quality lycra underwear. It holds everything nice and snug to my body without interfering with Wee Willie's (my stoma) function. I wear the bag at an angle diagonally across my belly so that the load is evenly spread when the bag begins to fill. The lycra underwear also helps to support the bag and stops it from dragging on the wafer.

It would also be kinder on your skin of you were to use a no-sting stoma adhesive remover. I use an orange oil based remover that leaves my skin in excellent condition. You do have to make sure your skin is squeaky clean and free of any oily residue before you put a new wafer on though. You can also get spray adhesive removers if that is easier for you. The moldable wafers really are designed to stick very well so it is important not to pull the wafer off without using anything. Also rather than pulling the wafer up from your skin, push your skin down away from the wafer when removing it as it will cause less trauma.

If your skin has become a little sore then try getting into the shower after you've taken off your wafer and aim the shower spray at the skin surrounding your stoma. This will help to stimulate the blood supply which in turn aids healing and it also feel really soothing.

I hope things settle down for you soon. Keep us posted.

Good luck and take care.

Shell

Hi..Thanks for everyone's help.
My skin is so sore under my wafer because I had to change it two days in a row because of leakage. My stoma nurse told me not to use anything but a wet cloth to get the wafer off. I don't think she realizes how bad it hurts. My skin is so sore. What do you recommend for helping ease the wafer off? My skin is so sore. What is the orange based remover called. My nurse didn't give me any ideas when she helped me with my order. It's only been since 2/19 so I expect a big learning curve here, but I feel really lost with all of this the past couple of days. I really want to see the stoma therapist tomorrow, but we are supposed to have another snow storm. Hopefully, my hubby can get me there with no problem. I hate taking our baby out in the icky weather though. She is 8 months old today!!

On the opposite side of my belly button issue, I have a stab site from surgery and have to cut a little of the tape to get it open to air. It was not healing being covered up all the time. My other problem, sorry I'm rambling, is that I have a gap between my stoma and skin, in one area. Is that normal? I can still see stitches, which I expect. They used my C-section scar to remove my colon and tha looks great. It was a lot less painful than my C-section down in that area.

Thanks to everyone. All this advice is so helpful. I'm just trying to get a system down since I will have this probably until the end of the year.

What do you use to keep your skin sqeaky clean before you apply your wafer? Also, the system I am using right now is the Convatec, durahesive moldable wafers (although I'm out of the ones the hospital gave me, and I have not received my order from Edgepark yet) and Sur-fit pouch. I don't know of anything else I should have. Is there something else I should have? Like I said, they nurse didn't give me any skincare options except warm wet cloths.

Any advice is greatly appreciated!! I feel so confused. I hope they didn't expect me to know all of this because I'm an RN. I tried to keep that a secret in the hospital, because I feel they assume you know everthing and don't tell important info. But all the nurses found out because they said I talk like a nurse. Whatever that means. I was totally medicated!! Ha Ha

Thanks everyone
Beth

Hi Beth,

I received my permanent ileostomy in July 2007, so I thought I'd chime in with some of my ideas.

I had my surgery done at the Cleveland Clinic in Weston, Florida. My ET nurse uses a product called "Remove" by Smith&Nephew to remove the wafer. It's very gentle and if you get the liquid (on the wipe) in between the skin and the tape, it desolves it quite quickly with less irritation. Edgepark sells it. I use dial soap when I feel I need some soap. I use just warm water and a soft washcloth most times because using soap all the time can be irritating to the skin I've found. Dial rinses off squeaky clean.

I have stopped using a hair dryer and just fan myself dry with the flange plastic container that the moldable wafer comes in. I find this to be more gentle on the skin. I use 4 X 4 squares of gauze, open them up a little and wrap the stoma while I'm in the middle of an appliance change. I've found that the gauze is easier than cotton balls, tissues, etc. to catch any leakage from the stoma during a change.

Lastly, the Cleveland Clinic uses a product called "Cover-Roll" stretch and I love it. There was a box left in my room and I took it home with me after my last surgery. I'm glad I did. It is manufactered by a company called BSN Medical GmbH & Co. KG (Product Ref. #45549-00). It's made in Hamburg, Germany and comes on a roll. It's similar to the white tape around the wafer but with a bit of stretch to it. It is hypoallergenic, water proof, and air-permeable. When my tape around the wafer starts to lift a little, I just cut a square of this stuff, apply it, and I'm good to go until I do my next appliance change. I had never heard of this "Cover-Roll" before, but the Cleveland Clnic in Weston uses it, so it must be a good product.

I hope these little suggestions help. I had a slipped stitch next to the stoma right after surgery and it just took time for the area to fill in. Be patient; all will work out in time. You're still healing.

Good luck to you,

Caty

use allkare remover wipes to ease the flange off gently- no way just water!
wash with ivory or dial
possible granuloma where that gap is
order no sting spray and stomahesive powder
and mitrazol powder and allkare adhesive remover wipes and no sting prep pads and no sting spray

looks like we all posted at the same time
shell knows much more than I do but the things i mention are always good to have on hand

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