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Posted 1/10/2009 1:56 AM (GMT 0)
OK,
so i've only changed my ileostomy bag once by myself (I mean out of the hospital)-but with the help of my husband. We changed it last Sat. and we thought it went great. We went a little paste crazy, but it seemed ok. The bag has been doing great and feels fine. no burning, stinging, itching. But I got some new appliances and it's been 6 days so we wanted to change it. Well, when we took off the old bag, the skin on one side of the stoma has begun to separate from the stoma! It's bleeding a little too.
Is this normal? I called an RN and she said maybe the stoma is just shrinking-possibly normal.
I'm not happy with possibly normal (since my last ileostomy leaked into my abdomen causing peritonitis)
We went ahead with the new bag and a bit too much paste again. It feels ok. Maybe a little bit of burning in that area.
I don't know what to do and I'm scared now.
Any thoughts?
Posted 1/10/2009 3:22 AM (GMT 0)
If it were me, I would go get it checked out. 

Posted 1/10/2009 3:39 AM (GMT 0)
like right now? the ER? or could it wait until tomorrow?
Posted 1/10/2009 4:00 AM (GMT 0)
Are you sure that it isn't just skin irritation from the paste wearing away? That COULD almost look like the skin is pulling away. And if it stings when you apply the paste, it probably is tender in that area. Don't change the bag everyday if it is not needed, but do so at the first sign of itching. Don't forget to push the skin away from the wafer rather than pulling the wafer off of the skin. If it is worse or feels really itchy, call your ET nurse.
Posted 1/10/2009 4:10 AM (GMT 0)
on the right side of the stoma "bubble" , the skin looks pulled away. My husband has mentioned b4 that the area of skin wasn't perfectly circular (kind of rough and ragged). and you can see the sutures......2 of them. It looks pulled away about 1/8 in.
The left side looks great and the skin hugs the stoma nicely.
The whole thing stings for a short time (a few seconds) when I first apply the bag. But then it goes away and doesn't itch. It does feel a bit tender. I figured it was just a bit irritated b/c I have sensitive skin.
We redid the bag again b/c I was worried that the hole was too small this time and I didn't want to injure the stoma anymore. When we pulled off the bag (the one we just put on) there was stool all under it. And I wouldn't have even known....
I hate this
Posted 1/10/2009 4:32 AM (GMT 0)
maybe it's a periostomal ulcer?
Posted 1/10/2009 4:35 AM (GMT 0)
Is it possible you left the first bag on too long and some stool caused the skin to breakdown on that one side?--just a thought. I would ring the doc or et nurse just to see what they say.
Posted 1/10/2009 4:56 AM (GMT 0)
I guess anything is possible. Is 6 days too long? The bag felt comfortable, so I thought it would be fine. How often should I change it if it's not leaking? I tried calling Dr. and ET nurses, but since it's after hours, no one to talk to, except that home health RN who didn't sound so sure. Could the paste have caused the stoma to pull away? Like I said, we used a bit too much paste and it was kind of all over the edges of the stoma. Does that harm it?
I really appreciate any ideas or answers you guys come up with.
Posted 1/10/2009 7:51 AM (GMT 0)
The paste shouldn't hurt the stoma at all. 6 days is excellent wear time. If the wafer is not breaking down and you don't feel "itchy" under it, that's how you can judge if 6 days is ok or not. It's hard to give you the black and white answers you are needing without seeing it, and I'm certainly not a doctor. I'd say hang in there until you can get someone, it your ostomy nurse or doctor, to look at it. Paste wouldn't cause damage to the stoma - you are using it for protection to keep feces off of the skin surrounding it. Does it hurt at all?
Posted 1/10/2009 1:44 PM (GMT 0)
If I remember, paste has a small amount of alcohol in it? -don't have a tube to check- That could cause the irritation on the sensitive skin at first...you may want to try 4 days next time, then 5 days if 4 was okay and back to 6 if you feel comfortable.

While it isn't the same for everyone...I could see my sutures for a while...if you pressed on that area and did anything come out?

I wish I could be more help...does your ET nursing program have a 24 hour service? My hospital has a skeleton ET nursing crew on over the weekends...maybe give your hospital a call and see?

Paste won't harm your stoma if it comes out around the hole, so don't worry about that part...
Posted 1/10/2009 3:01 PM (GMT 0)
It is only sensitive. It doesn't hurt. I look at it and think it will, especially now that the skin is pulling away, but it doesn't. The muscles under the stoma and my abdomen hurt still pretty bad, Which I would expect.
Yes stuff comes out of the separated skin area. Clear serum and a small amt. of blood.
We just covered it up again with paste and bag and I'll change the bag on Mon.
My ET nurse doesn't have 24 hr. service, but the home health care nurse does and she didn't know. I'll try to call again today and see if they can page an ET nurse. I dread having to change the bag again.
Posted 1/11/2009 8:39 PM (GMT 0)
My hubby and I changed the bag again last night, just to check on the stoma. Things are looking better. We are thinking maybe it was just the fit of the bag causing stoma to pull away. The skin was starting to hug the stoma again. It's only pulled away less that 1/8 in. but it is still a bit bloody. I didn't call my home health nurse and I'll just wait and call the ET nurse tomorrow. I really don't want to change the bag again, and I'm afraid that is what she'll want to do.
Posted 1/12/2009 8:11 PM (GMT 0)
UPDATE:
The ET nurse came over today to look at my stoma. She said what was happening is irritation and the skin is pulling away, but nothing to worry about. She just poured powder in that area and told me to continue to do that. The bleeding is normal too. Seeing the sutures is even ok-they will dissolve. But I was glad she put my fears to rest and said it looks ok.
Thanks for all of your help!
Chassity
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