how do you know when to change your appliance?

Hi everyone.  My surgery was on 2/19 and I came home from the hospital on  Tuesday, 2/24.  The surgeon did an open procedure, so I have a nice vertical scar from my belly to below .  I didn't take paiin meds all day yesterday, but may try some plain tylenol today.  My pain is mainly in my rear.  As I adjust to the new me, I keep reminding myself that I no longer have UC, and that I WILL heal from the surgery, where the UC would have progressively gotten worse and worse.  The surgeon said the right side of my colon was in the worst shape, which surprised me because my pain was always on the left side.

My question is, how do you know what your schedule is to change the appliance?  The nurse changed mine on Monday, and then I changed it again on Thursday.  I was going to wait and change it tomorrow, but for no other reason than the literature says to change things every three to five days.  So, besides having a leak or some other disaster, how do you decide when to change?  Also, how big of a pouch do you wear? The pouches that were ordered for me fit in my underwear, and are smaller than the one used in the hospital.  It seems like I have to empty it a lot, but if I had a larger pouch I think the weight of more .....mmm..... stuff would cause me to want to empty it just as often.  Yesterday I just wanted to take the whole thing off just for a break,  Does anyone else ever feel that way? Thanks.

H!  Happy to hear your surgery is behind you.  It sounds like you are adjusting really well!  I change mine usually every 5 or 6 days...if I am lucky enough to get that much wear out of it before I sprout a leak...when I feel that "certain" itch, I know I have a leak and have to change sooner rather than later.  You will soon fall into a schedule that works best for you.  Everyone is different.  Good luck and be good to yourself while u r healing!!!.....Cheryl

I wait for the "itchies" usually, unless I have a trip planned and want to be worry free during it, like flying, etc. I do watch the calendar to try to remember to be thinking about it around day #5 - I can go 7 days usually.

more glory days,

Sorry, this isn't JUST all about me!

Hang in there. The post surgical process is one of discovery, aggravation and relief for many. You may find that you had no idea how sick you really were as you start to feel better. One of the best bits of advice I got from my GI guy (the surgeon I will always love and he's taken care of other family. He's wonderful!) - your whole system will be healing for a long time. You might get to a stage where you think you are over it and be off someplace - he used the grocery store as an example - and all of a sudden you are just exhausted. His advice was not to fight it, walk a way from the cart, go home! I only had it happen once but I was so grateful he had suggested it could happen. I did exactly that and took care of myself. Many of us (guilty!!!!!!) are not good at doing that. Allow for what you need, be willing to ask for help (I'm terrible at that, too). Heal and go on in the world!

Once you get the hang of it, and after your body has calmed down, it's usually nothing more than something you keep track of. I know lots of people change in the afternoon. I do mine mornings before work. Peel it off, shower, get it all dry and right back on. I don't think I allow ten minutes extra now. Some days, yes, it does fight me, ( ) but not most of the time!

Do continue to cut yourself slack, trust me!!!

Ohio, I haven't used Imodium. Do you take it in the morning before leaving for work, or before lunch? Are there potential problems with using it to slow things down? Right now it seems like when I eat lunch my stoma decides to become very noisy. I am imagining sitting in the faculty room at a table with four other people and having these noises spew forth. Would taking something like beano or gas x help this? Thanks for any advice you or anyone else can give. I know I must seem neurotic, but this is all so new, different, and life changing. I just want to get to the new nornal with the least amount of trauma as possible.

I know it's time to change the wafer when I start to get the itchies or the edge of the wafer starts to peel away from my skin. Most of the time, I can go a week, but sometimes it's sooner. As soon as I change the wafer, the itchies go away.

I like to lay out my supplies and cut the hole in the wafer before removing the old one. Once everything is ready, I remove the wafer with an adhesive remover wipe and take a shower to clean the skin around the stoma. I use Dove soap for sensitive skin.

Once I'm out of the shower, I towel dry the skin around the stoma, put some Calmoseptine Oinment on the skin closest to the stoma, put the Stomahesive paste around the hole in the wafer and apply it to my skin, pressing down for a minute or so to make sure I get a good seal.

I use the Coloplast Assura Extended Wear Wafer (item #2833) with a cloth covered pouch (item #13986). It's a two piece appliance. Since I usually get 7 days wear time with the wafer, I will snap on a new pouch halfway through the week, when the velcro closure shows some wear.

I also keep a cosmetic bag with my supplies handy, so I'm ready in case I ever need it when I'm away from home. I've had an ileostomy for over 3 years and have never had a leak, so I've never had to use the emergency kit. *knock on wood*

Sorry this was so long and detailed, but since you're new to all of this, I wanted to share what has worked so well for me over the years. Also, mint Listerine type mouthwash is an inexpensive and effective pouch deodorizer.

You're welcome. Calmoseptine Ointment protects the skin in case stuff gets on it. You can read more about it at www.calmoseptineointment.com

P.S. I have never felt bloated from Imodium and do not get a surge when it wears off.