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Stoma allergic to wafer?? Is it even possible?

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Posted 8/30/2013 1:01 AM (GMT 0)
For a few months now I've been using Convatec Durahesive wafer without tape edge, and it has treated me well. Over the past few weeks I noticed most days, that as the day went on my stoma would get QUITE swollen a lot of the time. When I would snap off my bag to look at it, it would often shrink back down a bit after a minute or two, but the, swell back up again once the bag was on. The swelling is both length and width. At the same time I also noticed a bulge around the area above my stoma. Considering these things I thought I might be developing a hernia. I saw my surgeon...she said it's very possible, but she couldn't be sure because it wasn't bulging at the time of my appointment, of course!!

SO.....as I ramble on! The last time I changed my wafer I saw that my skin had some irritation, which has never been a problem for me. I decided to change to a Hollister sample that I had received recently, just to see if it helped my skin. This is the 3rd time in the past few weeks I've worn the Hollister, and have realized my stoma doesn't swell as much when I'm wearing it. It still changes size during the day, but not so dramatically. Is it possible that I have developed a sensitivity to the Convatec wafer that effects both my skin and stoma?? I mentioned the irritation to my WOCN and she said it's either a reaction to the wafer or a yeast infection sort of thing?

Anyone have any insight or similar experience?
Posted 8/30/2013 2:04 AM (GMT 0)
I'll play devil's advocate, my stoma swelled and shrank in response to temperature changes. So if it was covered up with a lot of clothing, or in a hot shower, it would be large. When I took my appliance off and cleaned it with cool water, it got much smaller. Maybe it's "cold" when you snap the bag off and gets "warm" when the bag is back on? Also, if it's allergic to the wafer, snapping the bag off wouldn't make a difference...
Posted 8/30/2013 2:35 AM (GMT 0)
Thanks Pluot! That is a good theory, I just can't figure out why it does it in the Convatec bags but not the Hollister....very strange! Maybe Convatec bags are warmer...or the wafer more restrictive? Or maybe the allergens are trapped in the bag and when I snap it off the stoma gets fresh air?? Can you tell I think about this WAY too much....HA!!!
Posted 8/30/2013 9:01 PM (GMT 0)
hey what - sounds like you have one of those "special" stoma's that doesn't play well with all bags - in my mind, it seems absolutely plausible that ms stoma has indeed developed a disliking to the convattack bags - good thing you have other options - hope you find one that works -

anything else exciting going on in your world ?

Posted 8/31/2013 1:30 AM (GMT 0)
I have he same issue. I have a loop Ileostomy.  I wear a Hollister "Red" 1-1/4 Precut Convex Wafer, and High Output Pouch. I have experimented with Convatec and Coloplast. Whenever I tried using the Convatec of or Coloplast wafer, I noticed that the area around my stoma would feel itchy. Upon removing the wafer, my skin would be red and swollen. The Coloplast wafer would actually cause my skin to bleed and weep. I had to switch back to Hollister. The Holister works well for me.

The only issue I have is that I don't really need a two piece system. I like the simplicity and less bulk of the one piece. I wish Hollister made a One Piece Convex in the High Output Pouch. I have had good results with the Nu-Hope One Piece Convex High Output. Nu-Hope makes their stuff custom to what you need. You can call them, and they will make whatever you need. You can then order it from Edgepark.

I currently switch between the Hollister and Nu-Hope. It feels good for me to alternate because the pressure points of the convex wafer are in different areas for each brand. It gives my skin a break between changes. Hope you find something that works.

Posted 8/31/2013 3:50 AM (GMT 0)
Regarding the swollen/lengthened stoma-- mine does that just about every day regardless of what pouch I am wearing. When this happens my stoma gets really soft and floppy (which makes it wider) and sometimes it lengthens about 1/2 inch. I do wear Convatec Durahesive... but it happened with Coloplast too. I am almost positive it has to do with heat as it happens even more when I am exercising or on a hot day. It seems that the tissue that the stoma is made of just gets more relaxed when it is warm. I can tell that my stoma is not prolapsing as it is not telescoping. In almost three years this has never caused a problem so I don't worry about it. As soon as I take my pouch off... the stoma firms up and shrinks back down.

The skin issue sounds like a separate thing. That could be an allergy. Not sure on the bulge... I haven't experienced anything like that.
Posted 9/3/2013 10:37 PM (GMT 0)
Thanks, Blueheron! I think you and Pluot are correct about temperature playing a role in stoma size. It's not the case ALL the time, but very often I notice it is bigger when I am more active or in a warmer environment. He also seems to stick out a bit more when I really have to pee...maybe my bladder pushes against it somehow?

The skin thing is still bugging me, and is very frustrating since the first 5 months of my life with the stoma were pretty much irritation free. I've been switching between Convatec and Hollister lately, so if it's an allergy, I'm allergic to both! My WOCN suggested it could be a fungal infection of some sort and told me to get some powder at the drug store and see if that helps. Today was only the 2nd time I've had a chance to apply it....not sure yet if it's helping. I also wore a Sure Seal this past weekend, which hasn't bothered me in the past, but left some itchy redness behind this time....maybe my skin is getting more sensitive.

Also, this may be worth starting another thread...but I'll mention it. I had always used paste around the edge of my wafer near the stoma, but have recently been trying the rings. Both Hollister and Convatec's version seem to totally disintegrate by the time I take off my wafer, which hasn't been more than 4 dayss since I've started experimenting. Is that normal? Today I tried a Coloplast to see if that holds up better. The big problem seems to be that once the ring disintegrates it leaves a gap between wafer and skin that output can get under. I think I might try nothing but the wafer and see if less is more is the way to go for me. Of course, I'm totally open to suggestions!
Posted 9/4/2013 3:11 AM (GMT 0)
If the ring is disintegrating completely you might be cutting the wafer opening too big. Or, maybe you just aren't going to get four days of wear out of a ring.

Is the skin irritation itchy? Are there lots of red dots on the irritated area? In my experience that's what a fungal infection would look like. The powder helped when I had mine.
Posted 9/4/2013 4:42 AM (GMT 0)
If wearing a ring is going to reduce my wear time, I guess I'm just as well not using them at all. I don't think my wafer is being cut too big, it leaves maybe an eighth of an inch of the ring exposed.

My skin irritation gets itchy sometimes and there ARE quite a few red dots. Hopefully this powder helps take care of that. I've been using a skin barrier on top of the powder, and I don't think my skin likes that much either...geez!!

My WOCN also suggested taking the piece of the wafer that I cut out and sticking it somewhere else on my body to see if it causes irritation. That way I'll know if it's an allergy.

I might have to give Coloplast another try....I don't seem to remember them ever bothering me. You'd think at this point I'd be able to just pick a system/brand and stick with it...HA!
Posted 9/4/2013 4:54 AM (GMT 0)
Another possibility for the rash is bacterial folliculitis. It isn't something my stoma nurse originally thought of... she thought it was a yeast infection too but it just wouldn't go away with the powder. I only considered follicultis myself because I once got it on my legs many years prior and it looked exactly the same (that case started from razor burn and then spread all over my legs). My stoma nurse agreed it could be bacterial, so I asked my doctor and she prescribed antibiotics (amoxicillan). The itchy rash went away within a couple of weeks. Folliculitis can start from slight skin trauma... bacteria gets in an injured follicle and then spreads to others. Mine itched like crazy!!! I prevented it from happening again by using Niltac silicone-based adhesive remover to more gently peel up my wafers (I think it is called Sensi-care now that Convatec bought the company) and also by trimming the tape off my wafers and replacing it with strips a different tape type that is more stretchy and skin-friendly (3M Medipore). My skin did not like being under a big piece of non-stretchy tape on the Convatec wafers and that caused skin trauma too (I also tried tapeless wafers but their footprint was too large on my belly and they always peeled up when I moved a lot.) That is why I came up with my own taping method. The rash has never come back.

My Eakins erode by day four too and I can see a sliver of skin. However, it seems that there is enough Eakin residue left (even if I can barely see it) that my skin is still protected. If I go 5 days though, the output will start irritating my skin. I also always put 2-3 layers of Cavillon skin barrier (it comes in little sponge wipes) on the sliver of skin just around my stoma. Then I put an Eakin over that. This was a suggestion made by my stoma nurse. She said even that little layer of skin barrier can help and that of all the skin prep brands, she has heard that Cavillon is the most water and stool resistant. Those few layers of Cavillon have been successful in protecting my skin a little bit once the Eakin wears away. Again-- only for up to four days.

I cut my wafer 1/8 inch larger than my stoma all the way around. I can't cut them any smaller as I have a crazy dancer of a stoma that loves to expand and contract. I would strangle it if I cut my wafer right up to the edge.

Good luck!
Posted 9/5/2013 2:14 AM (GMT 0)
Thanks, Blueheron! I will definitely keep the possibility of bacterial folliculitis in mind. I am currently on a short prescription of Diflucan, for another issue...so maybe if it IS a yeast/fungal rash, that med will clear it up. If it still doesn't clear up, I will mention the bacterial possibility to my WOCN. She is out of the country for 9 more days, so I have some time to try and heal myself before I can get in touch with her.

If there is a certain product I'm having a reaction to, it could be tough to pin down, because I experiment with different brands a lot. Suppose I should use the same set up for a while and see what happens. That is a GREAT idea about cutting the tape off of wafers. I can't tolerate tape edges, and use the tapeless,but you are right....they are fairly large. What sort of tape do you use to create your own tape edge? The ones I have tried irritate me a bit also.

I don't know if I will bother to continue using the rings...I'm not sure they are really doing anything to benefit my setup. The bit of skin that is exposed between my stoma and wafer never seems to be bothered by any output that gets on it. I do want to get some more Cavillon barrier wipes and try the method you mention of layering some of that around the stoma for extra protection. I think maybe that and some paste might do well enough for me...but I'll still give the rings a fair chance too, since like yours, my stoma is also a bit of a dancing shape shifter and DOES need some extra space to wiggle about!

On a side note....CONGRATS on your recent mountain climb...that is SUPER impressive for anybody...stoma or not! I enjoy all sorts of hiking, camping, fishing, backpacking...and while I've gotten back to some of that, nothing ANYwhere close to your achievement. I'm actually disappointed with my post surgery activity level and need to motivate myself to start doing more day to day.
Posted 9/9/2013 12:51 AM (GMT 0)
UCwhat?
Have you read any of my posts regarding Friar's balsam compound benzoin tincture or the benzoin tincture swabs? It may be just what you need.

Dan
Posted 9/9/2013 5:04 PM (GMT 0)
I use 3M Medipore tape (in the 2-inch wide roll). It is the same tape surgeons and nurses often use to attach dressings after surgery because it is so gentle on the skin. I cut the tape into little strips (so they stretch lengthwise) and reinforce the circular part of my wafer onto my skin with them. This seems to give my skin the ultimate ability to move with my wafer. They stay on great too through swimming, hot tub soaking, hiking and rockclimbing in hot temps, yoga, and everything I do. The blog post below has a photo of my method, though it shows that I used to keep on part of the Convatec wafer tape along the bottom. That small bit still bugged my skin, so nowadays I trim all of the wafer tape off and put my 3M strips all the way around the circular part of the wafer. 3m Medipore tape is usually not found at the regular drug store but can easily be bought online. One roll lasts a very long time because I use such a small quantity with each wafer change.

http://ostomyoutdoors.com/2012/06/12/skin-sleuthing/
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