Hi John! I agree with almost everything suggested above, but I thought I'd give you a bit of my experience too...
1) I actually shower with my appliance completely off when it's time to change it...which is about once a week. I used to change it every three to four days, but now am up to every six to eight days!
2) Yes sir, I do clean my stoma in the shower. I scrub fairly hard on the skin under the skin barrier and my stoma as well. I don't mind the bleeding. I also don't mind if there are some messes in the bath tub. I try to shower before having breakfast or immediately after dinner so my stoma (Penelope) isn't in over drive. I also clean the skin in the shower and dry it off with a washrag (so the blood from Penelope doesn't stain my towels) and I make sure my skin is as dry as possible before adding the Eakin Seal, and I do try to keep the seal as close to her as possible.
3) I tried the paste for the first month or so, but learned it just wasn't for me. I now use the Eakin Seals by ConvaTec...or is it Coloplast...hmmm...sorry I don't really remember right now! I also learned that each brand and style of flange/skin barrier/wafer will fit differently. I really think you may need to experiment with them and find what is best for your body. I tried two-piece systems for a while, but decided that one-pieces are what I need, and after additional trial and errors I have found my match! If you call around to all the different companies they will be more than happy to send you trials of anything and everything! I have to admit that I have been most impressed with Hollister and Coloplast for the appliances and ConvaTec for the seals...again, I think that's right.
4) I hated seeing my stitches...they broke off and just kind of stuck out around Penelope like huge nasty hairs! Totally gross. However, they did fall out over time. Most of mine were actually pulled out b/c they were attached to the skin barriers! That was weird too.
I do suggest that maybe give yourself some time to heal before exposing your stoma to a lot of water. The first time I took a shower completely nudie was about a month post surgery...I had a blockage (broccoli...beware!!!!!) and soaked in a hot tub and took a hot shower and Penelope was okay...she was traumatized b/c of the stupid broccoli, but the shower and bath didn't hurt her.
It is weird how the skin and stoma are...it's hard to explain...in a way mine looks like it's just there, but Penelope is secure...
I like seeing Penelope. She's a part of me and I accept every bit of her presence. When she makes little noises or BIG noises everyone (my family and friends) knows it's her being obnoxious!
Sorry this is so long...I hope you continue positive adjustments!!!!