Thank you for replying to my previous post, and you've all been helpful.

I'm having some issues finding the correct appliance. Mostly because of a few issues. First of all, since they've taken the rod out the stoma opening faces in and downward. It sprays right on the skin below the opening. As a result, the skin around the stoma has been extremely excoriated. I've truied using a barrier but because I've been changing the appliance so frequently, it's getting worse. How can I get the stoma to point upwards. Many have suggested the moldable wafer by convatec. Would this help in this regard?

my second problem is that my staples were just removed and my stitches are getting the worst of it. Because of the leaks, and it's close proximity to the stoma site, there is a high risk of infection. Once again, the nearby stoma is hard to seal as well because of the depression due to the incision. It makes finding an appliance very difficult.

Is there anything that can be done? is this problem beyond solving?

This message has been edited. Last edited by: Blowe,

Hi Blowe,

Yes, the Convatec moldable convex wafers will help to push your stoma out away from your skin. These wafers also have healing properties similar to eakin seals so should help with the excotiated skin.

Make sure when you put a new wafer on that the area is really dry with no stoma drool (that clear stuff) getting into contact with the underside of the wafer. To achieve this I use a small square of Bounty kitchen roll which I wrap around Wee Willie to soak up the moisture. I change it regularly until I'm ready to apply my new wafer and then I quickly whip it off and place the wafer before it gets moist again.

If the skin is weeping then apply some stomahesive powder first and brush off any excess before spraying with a no-sting barrier such as Cavilon or pat over gently with a no-sting barrier wipe. Make sure the whole area is dry before applying the wafer. A hairdrier on low setting will speed things up.

Trust me, no problem is beyond solving. We'll get you sorted out between us.

Good luck and keep us posted.

Shell

I have been in a similiar situation as you.

What is working for me is I use convex wafers (hollister in my case). If you are a guy and you have chest hair like myself, make sure you shave it, I go over it every change. I was having some weeping, make sure you use the stoma poweder. What I also did after the appliance was on, I'd put some gauze pads on top of the wafer tape/sticker area to absorb the weeping from the tape/sticker. Also, make sure you wear a properly fitted ostomy belt. It will help push your stoma out when you are sitting.

Once I was able to keep a wafer on for 4 days, I have been healing up better. My excoriated spot on below my stoma is getting smaller.

Good luck and keep at it, don't get discouraged!

Hey everyone

Thank you for the kind words. My nurse saw me again today and nothing has worked so far. She put me on these hollister wafers/barriers and they're great at masking the depression of hte incision but the leaking continues.

The real issue is the fact that since the rod has been removed the opening is fully down and inward towards the skin . My nurse said the moldable wafers won't help because the opening is so close to the skin that it can't "turtleneck" the stoma well enough to prevent leaking.

I'm at my wits end. What is the difference between the moldable convex vs the standard moldable wafers?

thanks

The only difference is that convex moldables will push your stoma out like the Hollister convex wafer you are using. Both the flat and convex moldable wafers are Durahesive rather than Stomahesive (most other types of wafers are stomahesive) so much better suited to the high watery output of a loop ileo. In fact they stick even tighter when they get wet (which is what I love about them) and if I have to change my wafer early for any reason I actually have a hard job getting it off it sticks so securely. They also have healing properties in the adhesive so your skin will heal much faster than if you are using just the regular stomahesive wafers.

The other thing I swear by in helping the skin to heal is to get in the shower without your appliance and aim the shower head at the skin around (not on) your stoma for about 10 minutes. This not only feels really soothing it also stimulates the blood supply to the area which in turn speeds up the healing process.

When I get out of the shower I put a small square of Bounty kitchen roll over Wee Willie to soak up any moisture and catch any output while I get dried. I prefer Bounty because it's really absorbant and doesn't stick to the stoma like toilet paper. I change the piece of kitchen roll frequently until I'm ready to put my new wafer on as this stops Wee Willie making a lot of drool which might get caught under the wafer and undemine the seal.

At this point you really just need to keep experimenting until you find a system that works for you. If you go to Convatec's web site or ring their help line you can order samples of the moldable convex wafers to try. If you explain your situation they may be able to rush a sample order out to you.

Good luck. I hope you get this figured out soon.

Take care and keep us posted.

Shell

Thank you Shell

I have a couple of more questions if you don't mind. Because my stoma points downward and inward it usually leaks below the flange/wafter/barrier (whatever it's called). My hope is to find the moldable barrier, and hold the stoma upright so the opening is upward, and then seal it with the barrier. Will this plan work? I am worried that the stoma will contract and expand, and break through the moldable barrier eventually.

Blowe, if you press down hard on the rim of the convex part while you are applying the wafer it should pop your stoma up at the same time, just make sure that the area of skin around your stoma is dry. Keep pressing on the wafer like this for about 5 minutes until the adhesive is well and truly stuck. You can put a wad of kitchen roll over your stoma to catch any spillage while you are pressing it. Then fix your bag in place and secure with yourt ostomy belt or wear some tight fitting lycra boxers. If possible try not to bend or sit for the next half hour so that the heat from your body can secure the bond even more.

Wee Willie tends to occasionally retract right down below skin level as well as telesope out to about 2 inches above. When he's retracted I have the same problem as you with stool getting under the wafer and it would completely blow off my old system as well as give me terribel skin problems. I also have a lot of raised scars around Wee Willie from some nasty peristomal ulcers a few years ago so the skin is very uneven and lumpy. The moldable wafers are the only ones that mold to every contour and actually stick even harder when in contact with fluid, so I'm very hopeful that they will work for you too.

Good luck.

Shell

I am having exactly the same problem with my stoma opening. The rod is in the process of falling out, and when I changed the bag yesterday, the stoma had definitely sunken in. I just made sure the Eakin seal on there really good, but I still think that my skin is going to be bad when I see the stoma nurst Thursday morning. Hopefully, they'll change my appliance to something that will push the stoma out then!

Is this normal for the stoma to be an "inny?" It kind of freaked me out yesterday when I saw it! I guess if it's still working, right?

Hi Tertenpin,

Unfortunately somethimes that's the nature of the beast with a loop ileostomy. They can tend to retract because they are being pulled in by both sides of the loop. I don't think there have been many folks on here with loop ileos that haven't needed a convex wafer.

Hope your stoma nurse can sort you out with something soon. It's better to tackle any potential skin problems before they happen because once the skin breaks down it's very hard to get a wafer to stick so it starts a cycle of leakage and skin problems.

Good luck.

Shell

Thanks for the info, Shell! I'm seeing the stoma nurse tomorrow, so hopefully they'll be able to do something for me with a convex wafer!

Terri

My husband had the EXACT same problem (and exact same stoma..haha) with his loop ileostomy. The nurses would tell us what to do,nothing worked. Danny finally found what Shell was using, worked for him..he got the convex moldable wafers..DURAHESIVE...but those did not always work alone..he also had to use paste first, then put the wafer on over that. He had an awful time with it. I hope yours is temporary...his first stoma..an end I assume..was not nearly as hard to deal with. Danny also had the problem with the incision getting dirty all the time. It never did get infected, though...we just made sure we cleaned it very well every time. I had to help him quite a few times with the last stoma..took two of us to get the job done most of the time.

I would also see if an ostomy belt would work for you. I know it helped keep my wafer closer to my skin and helped the stoma protrude out a bit more. Speak to your nurse or call the company of the brand of appliance you are using and have them send you a belt. I had a few, one for the gym, one for every day and one for the pool.

Good luck.

Well, we tried the convex moldable wafers, and the first one worked fine. But the next time we changed it, it popped right off! So, went to see the ET nurses yesterday, and now we're trying an oval Coloplast convex wafer to see if that works (it's ok thus far!). They did say that since the Activelife one-piece system by Convatec did give me a seal, that it would be ok to go back to them, even though they aren't convex. I just want to use what I get a good seal with, because I need to go back to work before step 2, which hopefully will be scheduled in late Jan. or early Feb.! So, I guess it's all an experiment.

One question, though. The Eakins seal has really "bubbled up" around the opening with this wafer. Stuff is still coming out, but should I be concerned about this and change the bag?

Thanks!

Terri

The eakins don't stay on as long as other past or caulking. The strip past by coloplast works best I believe. I would definitely change the bag now, especially since it's close to the incision site.

Eakins are good because they're better for the skin, but if they don't give you enough wear time, then you should consider switching.

What is working for me, albeit for a short time, is taking the coloplast skin barriers, cutting them up into small strips, and putting them over the incision site. This addition levels out the skin a bit more, and allows the wafer to stay on a bit longer. Again, it only has been a few tries.

Been There.

It (stinks)
I experimented with all brands and types of rigs.
Check my posts and especially JasonPa's for a long step by step method.

My abs went from a (near) 6pack to a minefield, looks like a cracked bowl that is upside down and missing a piece (a Crevice), nothing adhered.
Now:
I use Keraya powder, then permatype cement, then an Eakins seal, then a Hollister convex wafer then a Convatec 'snap-on' pouch (Yes, I mix brands-I swab the same cement on the 'tupperware' prior to snapping in/on), then wear the 'white' belt; and have gotten up to 6 days though I average about 5 days.

Get the free samples others recommend, expect some success, a fair amount of failure and eventually, you'll resolve this challenge &
you'll get a workable system.

Good Luck-Happy and HEALTHY New Year!!

Eric