something that ostomy nurse said doesnt make sense..

So, my hubby had his first appointment with our home care Ostomy nurse. And she suggested that he use a close ended bag and just throw away each time. While that sounds great, with not having to worry about emptying...is that really practical? The reason I ask is, I've never heard of anyone doing it this way. She said her father has an Ostomy and he does it this way. I know she's trying to be helpful and she said she wants to make this as least distruptive to his life as possible. Wouldn't it be really expensive to do it this way? And does anyone see any problems with this?

People with colostomies most often use those because their stool is more formed and it's hard to empty out of an open-ended pouch. If you have an ileo, unless you have very thick output, it's probably better to use an open-ended pouch.

Well, I just learned something here, thanks.

I'd be a bit mistrustful of that nurse, though..... are you sure she's an ostomy nurse? I found that the home nurses who weren't ostomy nurses said all kinds of things..... (love it when they say, "Can I see your stoma?" Um, no, I'm not taking off my opaque one piece pouch so you can take a peek.....)

     Wow, I am learning things here that I never knew before also!

      I have to agree with blueglass about making sure he has an ostomy nurse.  The first home care nurse that visited me when I was discharged from the hospital was very knowledgeable...however...this was on a Saturday and she only worked weekends.  The nurse who came on Monday knew NOTHING about ostomies and when she left I was practically in tears.  I was teaching HER things....lol.  OY...needless to say, I phoned the home care facility who send the nurses and requested a nurse who was at least familiar with how to take care of ostomy patients.  Things improved after that..lol.

BTW the irrigation option is only for colostomies, not for ileostomies like Madigascar's husband has. With a colostomy, output sits in the colon for many hours while fluids are reabsorbed (hence the thick/formed output for colostomies and for ordinary functional plumbing) and thus flushing it all out once a day can work. With an ileostomy, the output comes straight from the small intestine, there's no colon for it to sit in for hours and hours, and so irrigation would not work.

Marsky, when was first considering surgery and read about the irrigation option, I got excited, but it doesn't work for those of us w/no colon..... can see why another surgery is not a very exciting idea.....

This nurse is not all that knowledgeable at all. You will get better info here. The nurses at Mayo clinic were excellent. The home health nurses while very nice we found to be somewhat limited in their expertise. We used them for 11 of the 12 visits that fell in the timeframe given to us and did not pursue an extension.

Our main concern was having the surrounding area looked at and checked, his vitals etc but really found we were actually doing fine on our own with supplementing advice from here and another ostomy board.

I only needed to call Mayo clinic once to confirm some info as they are always available whether it be by phone or if we need to go in to have something looked at or tended to. So far having info available here has been a big help especially in the very beginning. Once we found and determined what appliance works best we are doing well.

madigascar
You might get better information/help from the nurses at Convatec. phone 800 422 8811. Give them a call.

Dan

bluegrass, my surgeon got real excited trying to get me to go for it a few years ago. Back then we had high copays, deductibles, etc. Now they're even higher and our insurance covers practically nothing. I'd never opt for this surgery unless I won the lotto or something! (and could quit my job). I did find a forum for irrigators on a cancer society group page I believe. Those that have most of their colon in tact and irrigate think it's the wave of the future (sounding like my surgeon). The part she lost me with was this - in between irrigations you simply wear a large bandaid (called an AM Patch). I must have gasped out loud because she said - I've lost you, right? I said - yeah you have! I'm just very skeptical anymore that these surgical procedures are as easy as surgeons say they are.

my home care nurse told me to just take a safety pin and put a small hole in my bag to let out gas! lots of time those nurses don't know much, not that they are bad nurses, just not something they deal with a lot. My husband is an ER nurse, and he knows very little about ostomies.
Anyway, the skin comment MAY apply if you have a lot of irration, then odd as it may sound, the more you change the more damage it can do. 5 days would be a lot at the beginning, only because the stoma is changing size so much and leaks are more common. Right now i'm attempting for 8 days, but im really nervous! it just came down to bad timing for me.
I also dont see how a moldable could damage the stoma it doesn't have sharp edges. Seems like the ones you cut would be more likely to have sharp edges. And honestly stomas are a lot harder to damage than you may think.

At the start you would normally change the bag more often than 5 days just to check on the healing and making sure everything looks ok still. There is good reason once all is healed ok to keep change of wafer/bag (depending if you use one piece or two piece) to as little as possible. More times it is changed can effect condition of skin, but it does depend on each person. Some manage 7-10 days some change every 3 days, find out what suits best.

Sealed/closed bags are really bad idea for ileostomy as output tends to be more liquid and empty more often. Colostomy is thicker output and maybe needs changing once or twice a day.

Mouldable wafers do not damage the stoma, in fact it is the opposite. As they are made of a flexible material they are actually softer on the stoma than a normal wafer. Also stomas are pretty resilient and even if you cut a wafer a little tight and only notice it on the next change it will soon be back to normal.

Think you need a change of stoma nurse to one who has an idea of what they are on about.

I think the gooey stuff is the adhesive from the flange or the eakin seal if you use it. But, as this is so new, you can just leave it and ask the nurse. In my case I just scrape off the adhesive very carefully with a really short finger nail being careful not to hit the stoma. Rosemary

I use both kinds of bags...open and closed. It is easier for me when I am out and about to just replace the bag than to try to empty into a public toilet...with having to clean the end of the bag and the possibility of getting my hands icky. I just hold the disposable garbage bag up to my wafer, take the bag off and immediately replace it with a new bag. It works wonderful for me. I have an ileostomy, so I don't know about different bags being for different kinds of stomas.

The boxes of open ended bags (Hollister) have 10 bags each...the closed ended bags have 60 in a box. I guess I am fortunate that my insurance covers it. But I definitely see benefits of both types of bags.

No, there is no medical reason. Just that ileostomies can produce more output and if one is using closed-end pouches they have to be swapped out more. I use drainables 90% of the time but I love using closed-end pouches when I am out hiking peaks and it would be difficult to dig a hole to empty. Or if I am on a day hike that is a super popular trail with lots of people around. Much easier to duck behind a tree and swap out a pouch than it is to dig a hole to empty. Closed end pouches are great any time it wouldn't be easy to empty. Though this hasn't happened yet, I always keep some with me in case I got caught in a huge multi-hour traffic jam in the mountains (common in Colorado when everyone is heading home to the city from the ski areas) and couldn't get to a bathroom to empty. They are really are easy to swap out as Allbetternow said. I just take the old one off, toss it into a little garbage bag (I find the small black ones used to pick up doggie doo work great) and snap a clean one on. If it will be a while until I can find a garbage to put it into, I also double bag it in a ziplock for packing out. It is good to practice swapping them out a few times, but once you get the hang of it, the process is not messy at all.