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21 yr old student/athlete, New to Ostomy and Seeking Advice

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Posted 10/7/2013 9:24 PM (GMT 0)
After a week long trip to Thailand with my sister I faced an onset of Crohn's Disease. I spent the last 4 months in pain and misery only to realize that all the medications/treatments my GI doc sent my way failed -- Prednisone, Remicade and 6MP. The final solution was removing my entire colon. Turns out it was the right decision because my entire colon was diseased and close to perforation. Now I'm 5 weeks out of the surgery and beginning to adjust to life with my Ostomy and stoma (whom I've named Walter). I've taken a semester off from college but hope to return in January. Until then I'd like to get a hold on things and gain back the 35lbs of muscle that the Prednisone stripped away from me.

Unfortunately I've had eczema and severely sensitive/dry skin my entire life, making this whole ordeal even more of a nightmare. I've gotten sample packages from Coloplast, Convatec and Hollister and after trying them all out and weighing the pros and cons of each I decided to stick to Coloplast because of how well/long their extended wear wafer stayed on. Since then I have ordered a supply of their Sensura Click XPRO Convex Light and their 2pc drainable pouches with filters. I also ordered Stomahesive powder and Coloplast's barrier rings.

Now, after a few more uses and changes of the Coloplast wafers, they are no longer sticking to my skin well, or even at all. I think this is because of the layer of Stomahesive Powder that I am putting on beforehand. Am I supposed to apply the barrier wipe film layer before AND after the powder? Are there any other tips for protecting sensitive skin but still ensuring adhesion of the wafers?

I am currently forced to using medical tape to keep my pouch on throughout the day and have had to change the entire system daily for a few days now. VERY FRUSTRATING AND INCONVENIENT. Any help or advice is greatly appreciated. This is all very new to me and rather daunting to say the least.
Posted 10/7/2013 9:47 PM (GMT 0)
Welcome to the forum and so sorry for your ordeal. Pleased to hear that you are uplifted and trying to adjust to this. Alot for someone your age.

Ask for all kinds of samples. It's all trial and error in the beginning.

For myself, I use Convetec Moldable Convex wafers. My stoma was inverted, so I needed convexity. Moldable took the quesswork out if it. The stoma paste didn't work for me, using a ring did...Eakin Seal. You've ordered the Coloplasts ring, hope that will work. When my skin was raw post-op, I alternated between powder and wipe, several times. The powder really hinders the weartime, so getting a good seal and letting your skin heal without it, is what is best in the end. Do you really need to apply the powder? What has the WOCN said? Others will chime in. You can also go through past threads and see what tips will assist you. My biggest tip is using a hairdryer. Maybe not for now if your skin in a compromised state.

:-)
Posted 10/7/2013 9:52 PM (GMT 0)
I have an inverted Stoma, and a very small one, which made it extremely difficult to take care of. Fortunately there is an angel of an Ostomy nurse I was able to set an appointment with and I haven't had a problem since. I highly suggest finding a good WOCN - Wound and Ostomy Care Nurse. I use eakin cohesive skin barrier rings with a convex wafer. I put the powder on the skin first and then the skin barrier wipe film after. I think it is very important you put it on after because it is what helps it stick to your skin. I have mine in a small spray bottle, instead of wipes now. I also use two Ostomy belts.
Posted 10/7/2013 10:09 PM (GMT 0)
Thanks for the responses! I already have a WOCN but she doesn't seem to be very knowledgeable on dealing with sensitive skin. I've taken to reading through tons of old forums and posts to get some help instead. I definitely plan on using a hair dryer during my application now.

I have a few questions:

1) What is the purpose/benefit of the convex wafers? I realize now that the supply of Coloplast wafers that I have are convexed. Do I want or even need them to be convexed or am I better off with a flat wafer?

2) If I don't apply the powder, should I still use the barrier wipes or spray to create a film layer?

3) Do you apply the powder everywhere surrounding your stoma, or just in specific areas that are red/irritated? My WOCN had me applying tons of it all over the place which seems a bit excessive.

Thanks again for the responses! AnnAmaze, sorry to hear how rough your journey has been, but at least you get to have a take-down in the future. It does make me feel a bit better seeing someone post that's around my age though!
Posted 10/7/2013 10:40 PM (GMT 0)
I'm a relative newbie to the ostomy, too (April 2013), but I've had great results with the following routine:

-- Prep as much as possible. Cut wafer to size, get all materials together, etc.

-- Take off old wafer/pouch in shower. (TIP: Hold down skin near where you are slowly peeling off the wafer to avoid unnecessary irritation.)

-- Wash area good with soap/water while in shower. Temporarily cover with paper towel square in case of leakage.

-- Wet another paper towel and lay down on bed.

-- Clean area one more time, then dry carefully.

-- Apply a material called CAVILON (made by 3M) to the skin that will adhese to the wafer. Allow to dry for 10 seconds or so. (Note: This stuff basically forms a "second skin" on top of your own skin for the wafer to attach to. This may be of particular interest in your case.)

-- Attach a barrier ring around the hole of the wafer (should probably do this as part of the "prep" cycle mentioned earlier). Not sure what Coloplast calls it, but it's basically a putty ring that's semi-sticky.

-- Stick on wafer and attach pouch. Surround the wafer with your hands and hold it there for 1-2 minutes. This warmth will allow better long-term adhesion.


I also always wear a stoma support garment so I don't feel the weight of the bag "hanging there". I also think this extends the life of the wafer/bag.

Hope this helps! I'm relatively young too (30), so I guess we're pretty much in this same boat together. Like you, I didn't really have the disease for very long before I was forced to have surgery due to multiple colon perforations. I went from completely healthy March 1 to a stoma by mid-April!
Posted 10/7/2013 11:14 PM (GMT 0)
With the powder, you are supposed to lightly dust it off. It will stick to the areas what need it.

I'm not sure what works better, but my WOCNs always have me stick Hollihesive over sores. Hollihesive is about a cm thick sticky sheet that goes between the skin and the adhesive of the pouch. You can cut it to sit on only the damaged areas. Alot of times I create a "washer" - I put the stoma through a stoma sized hole in the hollihesive. It's gentler than the bag adhesives.

Convexity is used when your stoma doesn't stick out away from your skin enough. That's so you can "push" the skin around the stoma inward. Convexity can also be a bit hard on the skin around the stoma as it puts pressure on the skin.
Posted 10/7/2013 11:29 PM (GMT 0)
Do you actually have skin irritation under your wafer, or are you just assuming it will develop due to past sensitive skin issues? Less is definitely more with stoma care.

If your stoma sticks out well from your skin and you don't have issues with output leaking under the wafer, then you don't need the convexity, and as mentioned above it can irritate the skin from the added pressure.
Posted 10/8/2013 12:56 AM (GMT 0)
Look for Polish Dans posts on Friars. It's still the only thing I use under my wafer.

Hopefully he will be along to give you some advice.
Posted 10/8/2013 1:13 AM (GMT 0)
And I just got a sample of the ProX clic as well. Hoping it helps with my loop ileo / wafer breakdown issues. Mine is flat though, Lily sticks out a ways.
Posted 10/8/2013 11:20 PM (GMT 0)
See if you can get a different ostomy nurse -- yours doesn't seem to know much. You definitely want to go "less is more," if you have sensitive skin -- putting powder everywhere is a big no, no, and she should know that. Also, try any new product elsewhere on your belly before putting it near your stoma, so that if you have a reaction, you won't have to deal w/it under the wafer (if you try a different brand of wafer, you can use a piece from the middle to see how the adhesive is for you). You might also want to see if there's a dermatologist that your surgeon works with.

You probably don't need a layer of barrier wipe, and that's just one more thing that can cause irritation. Use a little bit of powder where there is irritation and be sure to "crust" it with the barrier wipe otherwise it will make your wafer not stick. If you have a lot of irritation, you can put on a few layers alternating powder and wipe (end with the wipe).

You could also try an eakin seal or adapt ring -- these are sticky materials that go around the stoma. If your irritation is near your stoma, they often can protect the skin, and then you don't need powder.

I use convexity even though my stoma is long. The coloplast flat wafer is very floppy, and I have leaks with it, but not with the convex. My nurse switched me after a few months because my belly was soft, not because my stoma was short. Now my belly is firmer from exercise, and I could probably wear a flat with a different brand, but not with coloplast.

Hope you find something that works.... there is a lot of learning at the beginning.
Posted 10/10/2013 2:26 AM (GMT 0)
new to this too, wondering what an ostomy support garment looks like or where to get one? I hate the feel of the bag hanging.
Posted 10/10/2013 2:53 AM (GMT 0)
There are two support garments I can think of. The first is special underwear ( http://www.ostomysecrets.com/ ). You can try and make it by double layering the front panel of your own underwear.

People also use "belly bands" for pregnant women. They are just a strip of stretchy fabric that goes around the body. Put the ostomy bag under the stretchy band. Target has reasonably priced ones in the maternity section.
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