Ostomy on a small child - extremely irritated any suggestions

Francine~I am so sorry to hear you are having problems keeping your daughter's pouch on!

When you use the "no sting" preps around the tape part of the wafer, and the wafer gets wet, it will usually unstick (for lack of a better word)...

Here are a few questions:

1.What type of soap are you using?
2.Do you measure her size each time? When a stoma is new is can change a lot and if there is too much room it can leak.
3.Can you describe her stoma? does it stick out or does she have any skin folds? Are you using a convex wafer?

Hang in there...these are all issues most new ostomy patients deal with...you are not alone and we'll help the best we can!

i had to switch to the gold bar of dial soap, thats all that worked for me.
And the no sting pads def shorten the wear time.
She could be allergic to a certain kind i guess, you can always try another and see if that works.

Francine,
I have a 21 year old handicapped child, very small for his age (83 lbs). He has had his ileostomy for about 18mos now. I too went through the frustrations you are experiencing. In fact, his wafer is off every morning, due to the amount of gas and output he has at night. Amazingly, most of the time his skin remains healthy. When I bath him I don't use soap directly around where his wafer goes. I just wash it very well with warm water. I found that the skin preps made his skin worse so I normally don't use any. Occasionally he will have some yeast problems and when that occurs I use Nystain powder and a no sting spray barrier. That usually clears it within 2 days. We use Eakin Seals, but due to the insurance only allowing 5 per month we cut them into 1/3 and mold around his stoma prior to applying the wafer. Ialso found that certain wafers seemed to cause him more irritation. We use a one peice Coloplast, nothing fancy, but we can get 30 per month which is necessary since he requires a new one everyday. Occasionally, I use a different brand from samples I have received and have noticed irritation.
As everyone said, everybody is different and I know I tried many different wafers and combinations before finally determining what worked best. Still not great to have to change daily, but at least his skin is healthy. See if you can get samples from other companies and see if one causes less irriation than the other. Several of the different ones I have had are "smaller" and might work for a small child. Good Luck!

Thank you all
I am trying to get a WOC nurse in today or tomorrow. The skin is so bad that someone has to look at it. The only reason I don't want to change products is because Hollister is the only brand that has the "lock and roll". I'm dragging my feet on switching but I know that I may have to just try another brand. I have Convetec (sp?) samples but the woman only sent adult flanges..not pediatric and they seem huge. I am hoping the WOC nurse will bring some samples with her.

As for the gas and output my dd has the same issues every morning. but luckily for us, she is young and sleeps in our bed. I open her bag at least 2-3 times a night to let the gas out. Otherwise there were times she lied directly on top of it and popped it like a balloon because it was so full. Not sure how long she can last in our bed though since none of us are getting a good nights sleep.
thank you again for all the suggestions.
I am going to try something different the next time we change it.

J's mom~yes, I'm Buckeye by marriage!

One way to try would be to call/email the manufacturer(s) directly and get a bunch of samples. Just make sure you request that they send the really big pouches, too. I have found that is the best way to try something different before investing in a purchase or trying to get it approved. If it works, you could argue that they'd save money by letting you adjust the order!!

Francine~is Katie any better and were you able to get a WOCN in?

Francine - I'm so sorry to hear of all the problems that you are having with Katie's appliance and skin. I hope that the nurse is/was able to help today. There is a lot of information on the jpouch.org forum about skin problems for people with ostomies and also on uoaa.org. One posting in particular on jpouch.org is for a person that had major skin issues (2nd degree burns under her wafer) and has listed many of the things that she tried and others suggested to fix her skin so that she could keep a wafer on and her skin could heal. Go to www.jpouch.org and go to jpouch forums. Search in the general discussion for "Need incision and ostomy help-yesterday!!" and you will find the message thread. There may be some information that you can use in it.

I do know that all the WOCN's that I've seen have recommended and as many people that have posted have said - less product is better. With both my end and now my loop ileo I use stoma powder if my skin is irritated, followed by the wafer with some adapt barrier (the ring not the cream) on the wafer around the hole and that is it. I did find out that due to my allergies I had to use an adhesive remover to get all the adhesive from the old flange off or my skin would turn red and weep. That may help to resolve the pain issue with pulling off the wafer vs using the no sting barrier. I would recommend that you get one of the ones w/o alcohol or it will sting on the open sores and clean well after you use it as they are oil. Also, in case no one has suggested this, push the skin away from the wafer rather than peeling the wafer up. I found this suggestion when I was having weeping skin problems and have found that by using the adhesive remover, pushing the skin away, and shaving where the wafer goes when I change I have had great success with not causing additional skin problems (other than those caused by leakage because I waited to long to change). I also found that if my output was thick that I had more problems with leakage than if it was thinner. The thick output would always pancake on me and then force itself under the appliance rather than falling down to the bottom of the bag. Due to my adhesive allergies I use a wafer that has no tape around it. It is a Hollister new image 2 piece with a lock and roll bag. So far I know that both hollister and convatec have no-tape wafers and I'm guessing that all suppliers do.

Is your daughter wearing a belt? I'm guessing that as a 3 year old she probably moves around a lot and a belt could help to get a little longer use out of her appliance. I wear one 24*7 except for when I shower. I was in a 4" nu-hope and now am in a 5" with my loop ileo due to the appliance size. They work very well for me to get the wafer to stay on. If I don't wear one I have to change in 36 hours or less due to leaks. I do have some crevices around my stoma which are flattened out by the belt in addition to helping to hold the wafer on. I'm guessing that a smaller one would work for her (not sure of her appliance size). The 1" belt did nothing for me as it got looser as I moved around.

I hope that you can find a solution soon to keep her appliance on for longer and also can get her skin healed.

Ok, I changed my dd's appliance today. It was on for about a day and a half, so it's lasting a little longer than before. I've been told that a day on a child is very good. I am hoping over time it will last longer though.
Her skin looks a lot better. Not as red and irritated as before. Just a little patchy red spots. The nurse that was here today said it looked more like a yeast infection than a leakage problem. but she isn't a woc nurse and hasn't dealt with ostomy issues in years. So I am hoping a woc nurse will visit sometime early next week.
I am getting a perfect fit and there doesn't seem to be any leakage anymore so maybe as her skin heals the bag will stay on a little longer.
thank you again for all the advice. I think my mistake was using an adult wafer on my dd. She is so tiny, less than 30 lbs. the wafer was way too big for her. It leaked just not bad enough to get past the tape. So lesson learned on my behalf.
thanks again,

Im so  glad you are getting things alittle better anyway! Hopefully it will keep going better.

J'sMom-I have some eakin seal type things, only another brand, that i dont use.  I saw that you were having to cut them into tiny pieces.  Ifyou like i can send you a box and see if they work for him.  Just let me know

Summerstorm,

That is very generous. I would love to try the seals that you have. My email is [email protected]. Shoot me an email and I will give you my address. Also let me know what the shipping is and I will gladly reimburse you.
Sorry so late with the response, I have not had much computer time lately,,,,busy, busy, busy.
Thanks!!