"Volcano shaped" stoma

I have posted intermittently about trouble I've had with wear time. For almost the first two years after surgery, I got 4-5 days with a coloplast sensura one piece and an eakin. Then I started getting output under the eakin after only two days -- enough so it was hurting my skin and causing discomfort.

Note that the eakin wasn't melting, as they do, but the output was getting under it, and I was not understanding the mechanism.

I started trying a bunch of different products, none of which made a big difference, and saw my stoma nurse. She commented that my stoma is "volcano shaped," which it is -- it's pointy and its 2D side view is a triangle, not a rectangle, as it would be with a stoma that's shaped more like a cylinder. My nurse said moldables were a bad idea for me because they wouldn't hug my stoma. It was also clear that my skin was looking quite good compared to what she tends to see all day....

My partner, who doesn't look at my stoma all that often, said that the shape has changed and it used to be more cylindrical; I can't really remember (for newbies, if it's not too weird for you, I recommend taking occasional photos of your stoma for reference....wish I'd done that).

Then I tried a sample of an eakin alternative, the integrity ring, which is much harder and was advertised as not melting. For me, it was terrible, and I had to change the pouch the next day, but it helped me see what's going on because it swelled up into a rigid cylinder, and I could understand how my pointy stoma was getting output under it (lots of output with that ring).

Where I'm at now is using the 2 piece coloplast x pro, with an adapt ring under it, and some strip paste on top of the wafer near my stoma. I am just on the second time experimenting with this method -- the stoma nurse at the support group I go to (not my nurse) suggested trying strip paste instead of an eakin and that was not good, but I saw on the strip paste directions that you can put it on top of the wafer, and so far that seems to help. I got 4 days with the skin around my stoma almost perfect. But some other things I've tried worked well once or twice then didn't pan out, so will reserve judgement. I also want to try using stoma paste instead of strip paste (but the tube I have now is dried out).

In any case, sorry about the rambling, but I was just wondering if anyone else has a pointy, "volcano shaped" stoma, and if so if you've had similar problems, have other solutions etc..... or just if anyone has vaguely relevant thoughts/ideas....

My stoma is shaped like that, but then it is also on the long side so it is sort of a tipped over volcano:)

I have good luck with Eakins, but do find that sometimes the output seeps under the area right next to my stoma. It doesn't cause a leak, but does irritate my skin. After putting on my wafer over my Eakin, I do a couple different things. Sometimes I rip a small bit off another Eakin and form it into a thin snake shape. I then then put this snake shape around my stoma in the thin crack between my wafer and stoma and sort of work it in so it sticks. Eventually this extra piece sort of melds with the other Eakin that is already under the wafer and affords a little extra protection.

A second option that works really well too is to take some stoma paste and work it into that same crack between the stoma and wafer. Eventually this paste does erode away, but in the meantime, the Eakin underneath has had a chance to swell and melt into my skin more without output getting under it. Even with these methods, I can't go longer then four days between changes or my skin suffers (three days is better yet for me).

It is a bit hard to describe this technique. Hope this makes sense!

Have you tried an Adapt Ring instead of an Eakin? Just an idea. With my body chemistry the Eakins tend to break down a lot faster than the Adapts. Everyone's different

Pluot, I have been using adapt rings lately -- they seem to work a little bit better for me than eakins (but I seem to think of "eakin" as a generic name, like "kleenex").

Ddd, yes that makes sense, thanks -- another variation of a similar principle -- seal inside wafer as well as outside (or over as well as under). Makes me optimistic that something along this lines will work longer term for me, as it has for several of you.

Thanks!