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Flanges keep leaking

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Posted 4/20/2011 3:50 PM (GMT 0)
I have had several temp ostomies before but now I have a perm.

My output has been so much, I require Sandostatin shots in addition to Questran, Metamucil, Imodium, and Lomotil. The problem is that after my 2 AM BM, the stool turns watery until the next afternoon when it begins to thicken up again. That time between 2 AM and when I get up, the watery stools loosen the flange by puddling in the bag while I sleep on my back. I have had intermittent luck withSure Seals to contain it but I can not depend on it lasting more than a day or so. I try to keep track of what I did to get 2-3 days out of a change by trying bigger flanges (all 1 1/4" stoma), convex wafers, etc.

Four days ago it came off during the night and rather than wake my wife, I just got cleaned up and slapped on a one piece flat outfit with a small Sure Seal while standing in front of the mirror then went back to bed. That quick repair lasted 3 days! However, yesterday while laying, my wife prepped the skin, put on a wafer with more area, and a big Sure seal. Everything looked great for a good install. This morning it started to turn brown around on part of the edge. This was what I thought the safest combination. The only thing diffeent than my quick fix was this time I was laying down and this time she prepped the skin.

Without the Sandostatin I will quickly dehydrate so I don't dare stop.

Comments anybody? I need help.

Dave D

 

Posted 4/20/2011 6:52 PM (GMT 0)
I also can have a high output stoma that can be very watery at times, which it was before Xmas when had a bad CD flare. Even then though the only time I had problems with leakage was when it produced too much and forced under the wafer, not because it was too watery but because of the amount as I was having to empty every 40 mins and if I tried to sleep obviously this could cause a problem.

I have tried sure seals and they don't stick very well to me or the wafer. I use a two piece system by convatec and the wafer has the ring of adhesive then an outer square of what reminds me of mefix tape. This sticks really well to the skin.

I would recommend trying to avoid skin prep as some have said it reduces the adhesion of the wafer, make sure when you cut wafer it is really tight to the stoma so no room for stuff to leak under. Other thing you could try in stomahesive paste to fill in any gaps or the mouldable putty stuff which you can mould around stoma and bag to create good seal with no gaps.

Hope they manage to get your output to slow down soon, having been through it for 6 months know what a tiring nightmare it is. I changed to a low residue diet and cut out caffeine and ended up on humira, azathioprine, codeine, immodium, simethicone and supplements. Not sure which but worked but something is as def getting better and starting to eat what I want again.  

Posted 4/20/2011 9:09 PM (GMT 0)
I think you figured it out for yourself...don't lay down when changing your appliance! If it works, don't worry about it:)

Some times we over think things and use too many products. I really think less is more and the skin preps and adhesive removers leave a residue that can interfere with the wafer's ability to adhere.
Posted 4/20/2011 9:46 PM (GMT 0)
Thanks you two for your informative "Been there," comments. Diarrhea has plagued me for some time. Before the end ileo surgery in Feb. I was hospitalized with renal shutdown and low blood pressure due to dehydration even after taking opiates like Tinctures of Opium....nasty tasting stuff. I practically jumped on the operating table to get rid of the J-pouch, hoping to end the diarrhea. Unfortunately, after the surgery I was passing 3 Liters per day and going down fast. My surgeon put me on Sandostatin and I was able to get off the TPN. My G.I. then got my Hemotologist to put me on a shot every 4 weeks instead of 3 per day. The monthly shots are killers at a Medicare price of $3,500 each and now to slow me up, I will get them every 3 weeks instead. I really hope they help and Medicare doesn't abandon me. An hour ago my wife and I changed me....standing up. I was bleeding a little around the stoma so she insisted on prepping the skin. We'll see how this one goes cause I too can fill a 12" bag in 40 minutes.
Dave D
Posted 4/20/2011 10:18 PM (GMT 0)
skin preps can help protect the skin, but they really do reduce wear time as do barrier sprays and even powders. As long as your skin isn't irritated skip all of them. Standing up will help if your stomach isn't super flat. I hate when i get changed at my nurses office because she makes me lay semi flat and because i have a dip in my belly within a few hours my wafer is all wrinkled and the dip that gets filled in with paste is sticking out and I can't get it back in.

Have you tired different products recently? Maybe you are having some kind of weird reaction to the one you are used to using and you just need a different adhesive. And if a flat one worked well try that again rather than the convex. I can't get a good seal at all with a convex, it pops off in just a few hours. Either that or my skin begins to break down so I create light convexity with just an eakin ring.

I hope you are able to get your output down soon! That really diminishes wear time too. Good luck to you!
Posted 4/21/2011 12:29 AM (GMT 0)
betsaronie
I had the same problem with convex coming loose. Due to necessity I had to go back to a convex wafer. I changed to Convatec SUR-FIT Natura durahesive with Convex-it in January. Have not had a wafer come loose from the outside or at the stoma. I have one piece and two piece.

Dan
Posted 4/22/2011 1:54 AM (GMT 0)
Hubby has tried the Convatek Sur Fit Natura 2 piece system. First one on for 5 days and when he removed it his skin looked much improved. There was NO leaking and he really didn't need to change it but we decided to. We used another one on Monday and it is doing just fine..if it continues we will probably change it on Sunday and get 6 days.

We only put a bit of the skin prep on before putting the wafer on and eliminated the adapt ring and the paste at the 2 areas we were instructed to do after the surgery.

My husband needs convexity as his stoma doesn't protrude a lot but with all the leaking that was going on I reasoned that possibly we were providing too much convexity adding a seal and paste as he has put on 8 lbs since surgery and I think we were causing stuff to work its way under the wafer.

So far so good....looks like the adhesive on this wafer doesn't irritate him like the hollister wafer or at least for the time being.
Posted 4/22/2011 2:55 AM (GMT 0)
skin prep gives me like 5 minute wear time, the minute it gets the tiniest bit wet, even from sweat it pops right off! so i just go with paste and the bag, and a sure seal. 

i do lay down while applying, partly because it makes my stomach flatter, but a bigger reason (an odd one)  is that i can't see over these stupid big breasts standing up!  darn cookies always getting in the way!

Posted 4/22/2011 12:28 PM (GMT 0)
Starting day 3 on the same wafer! The trick was doing the change standing up!
Dave D
btw, summerstorm, big breasts aren't all bad. However, I don't remember why.
Posted 4/22/2011 2:32 PM (GMT 0)
Dave, LOL!
Posted 4/23/2011 2:02 AM (GMT 0)
UC wife
Do "you" use pouches with a filter ?

Dan
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