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Should I change my appliance now?

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Posted 1/26/2013 12:50 AM (GMT 0)
I changed my appliance yesterday. I wasn't totally confident about the size/shape when I cut the wafer, but I was working with a nurse who said it looked fine so I went ahead. Today I've felt some pain and itching around my stoma. Does that mean I might be having some seepage under the wafer? Would I feel it so soon? I'm not having any problems with leakage at all, and my surgery was recent so I suppose it could be pain from that, not skin irritation. On the other hand, I don't want to just let it go and find when I do my appliance change in a few days that I've damaged my skin. What would you do?

edit: I took the bag off and used a mirror to look all around the stoma and I can see now that there's about 1/4" exposed skin under the stoma... leaning strongly towards changing...
Posted 1/26/2013 1:39 AM (GMT 0)
If I don't have a snug fit I find that stool gets on my skin and causes itching and a rash. I recommend changing it.

I see you had surgery recently. How are you feeling?
Posted 1/26/2013 2:02 AM (GMT 0)
Well I changed it. I'm glad I did... I was worried I would hurt myself pulling off the adhesive after only one day but the adhesive was barely stuck to my skin because the nurse caked on so much powder yesterday. I *thought* it felt like the barrier stickers weren't really "on" all day but I figured I was being neurotic, but they really just... were not really on.

I re-measured and cut a new wafer and got a snug fit this time. The WOCN in the hospital told me that my stoma is oval shaped so I should cut different measurements for vertical/horizontal, but the visiting nurse who helped me yesterday insisted I should just cut a round shape -- I should have stood up for myself, but I figured he does this all the time and I should trust his expertise. My only concern now is that it might be TOO snug? How would I know?

This was my first time doing a change with no one helping or watching and I almost had a panic attack but in the end I got it done. I guess the end result can't be worse than the appliance I had on already so I have nothing to regret.

This incident notwithstanding I am doing really well. Eating well, moving around, not in much pain. Enjoying sleeping through the night (for the most part).
Posted 1/26/2013 5:09 AM (GMT 0)
I never cut mine into a specific shape, I just cut the wafer a tiny bit too small and the stoma filled itself in. If that makes sense. If its way too tight your stoma will be purple when you change. Probably it is not too tight. When you take the wafer off if its hard to pull off then you changed too soon. In your case sounds like the nurse used too much powder. Unless you have irriation don't use the powder. Less is more. Even when I have a bit of irratition I don't use powder because it shortens wear time and I have found that changing more often is harder on my skin.
Posted 1/26/2013 7:43 PM (GMT 0)
I always found the home-care nurses knew nothing about ostomies - even though they were supposed to. I knew way more than any of mine.

Glad you got it changed. That's a great milestone!
Posted 1/26/2013 8:50 PM (GMT 0)
Always go with what you know about your stoma. Mine is oval too and I have to cut my wafer taller (by a smidgen) than wider. I like mine snug and I change every 4-5 days. I like the clean feeling of a new wafer and bag.

Trust your instincts! You did well changing it on your own. I had to talk my way through the first couple changes, mostly reassuring myself and telling myself to breath. It does get easier. When I did my last change I had to sit and really think about if I did everything I usually do because it went soooo quickly. Ha ha!! All good though.
Posted 1/29/2013 3:21 AM (GMT 0)
I also ended up changing my wafer by myself at home for the first time today. The home-care nurse had changed it on Saturday but it had already started coming off and I was paranoid about it leaking so decided to take a shower and change it. While changing, I couldn't get all the old adhesive off, I still don't have any adhesive remover. Is that a problem or is it fine to have some adhesive leftover from the previous wafer?
Posted 1/29/2013 3:09 PM (GMT 0)
It is not a big deal to leave some of the adhesive on. You can try to rub it off by rolling your fingers over it. Personally, I never use adhesive removed because it is too harsh for my skin. I just wash with dial soap, warm water, and a wash cloth.

And you newbies... anytime you think you feel an itch, a slight burn, something strange under your wafer. CHANGE IT.. CHANGE IT .. CHANGE IT. It does not matter when you changed it last. Do not wait. You do not want your skin to potentially get bad as that is just a whole set of problems that are best to avoid. Also when taking off your old wafer, remember to push down on your skin rather than pulling up on the wafer. This helps to cause less trauma to your skin.
good luck!
Posted 1/29/2013 4:21 PM (GMT 0)
Liz,
I have to say, when I saw your question about "should I change my appliance" I had to giggle..it was almost like you were asking if you should get a new fridge/stove...sorry, just brought some humor to the day!
Glad you had the sense to change it and avoid any further complications! Good luck
Posted 1/29/2013 6:04 PM (GMT 0)

ddd45 said...

And you newbies... anytime you think you feel an itch, a slight burn, something strange under your wafer. CHANGE IT.. CHANGE IT .. CHANGE IT. It does not matter when you changed it last. Do not wait. You do not want your skin to potentially get bad as that is just a whole set of problems that are best to avoid. Also when taking off your old wafer, remember to push down on your skin rather than pulling up on the wafer. This helps to cause less trauma to your skin.
good luck!

Thank you :) This is something I'm struggling with a little bit because I do feel itching and burning around my wafer, but every time I've changed it (twice since I posted this) the peristomal skin looks and feels fine. I think it must be nerve pain from the incision that created the stoma. I have an appointment with a real WOCN on Friday so I will have her check things out but it seems that I can't really 'trust my feelings' in this regard right now

UCW, call one of the supply companies and ask for samples and mention adhesive remover specifically... I've used the Hollister and the Convatec ones and they seem pretty much the same to me. Blueheron also mentioned this one that Ostomy Secrets sells which is good because you don't have to worry about washing it off/interfering with the adhesion of your next barrier: http://ostomysecrets.myshopify.com/products/niltac-string-free-adhesive-remover-spray

mrsbugzy, LOL.
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