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General health and leaks / wafer hold time

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Posted 9/15/2015 12:51 AM (GMT 0)
Hello all...

The decision is made but I'm still waiting for the call to schedule a sit down with the surgeon before scheduling my perm. ileo. / proctocolectomy (i think I'm calling it right!)

I've noticed many great posts regarding wafer wear time and strategies for dealing with wafer hold problems. I'm wondering if anyone could comment on variables that might effect wear time such as general health / weight / drugs / other things; or is it just about finding the right products and applying them correctly.

I'm crazy underweight right now and feel like I have a great spot for where my stoma will go. While I'm super excited that I might actually be able to gain weight, my fear is that the weight will mess up my 'landing zone'.

I'm not really worried since I can only control very little here, but that doesn't make me any less curious.

Thanks,

ryan
Posted 9/15/2015 12:05 PM (GMT 0)
On my way to finding my current reliable 6-day wear time, I made changes in my products and gained nearly 20 pounds in the same time frame. I can't say for sure, but I do suspect the weight gain contributed to my success. After sugery, my stomach was, well, pretty ugly, wrinkled and flabby. I had lost a lot of weight during my illness. the weight gain smoothed things out and provided a firmer surface. I'd still rather not have the extra pounds, though. I was badly overweight when I got sick.

Changes in your stomach's profile may change the type of products you need to use, but I don't think would make it harder to find the right combo.

Ann
Posted 9/15/2015 12:11 PM (GMT 0)
I don't think general health/drugs would have any effect on wear time- it's an externally applied adhesive, you know? Weight could affect it, in the sense that the placement may shift a little if you gain/lose a fair amount of weight. I get about 7 days wear time with a wafer, regardless of my activiyt level. I swim 3x a week, about an hour each time, makes no difference with wear time. The one factor I've found to affect it is humidity- in the hot humid months, sweat can make wear time a little shorter. I gained about 15 lbs. overall post-op- lost weight right after surgery, gained some back, lost some more, then finally evened out & have been at the same weight for awhile now. I do remember when the WOCN marked the stoma placement, she took weight into consideration, the possibility of gaining or losing. Mention it at the appt. to be marked. Good luck!
Posted 9/15/2015 6:19 PM (GMT 0)
Actually the wafer hold time has been surprising for me, I never actually felt the need to change a wafer until the other day. I was in the habit of doing it about every 5 days. The other day, I don't know how long i was wearing that wafer, maybe 6 days, maybe 7 or 8, I didn't keep track. I finally pushed one to its limit. I always wondered, do you need to change it after 5 days... I didn't seem to need to. Well we had a major heatwave here and I hadn't changed that wafer in some time. Finally after a shower, the top of the wafer began to peel off. I could have probably stuck it back on or used a circular piece to get another day or two but I decided to change. I was actually excited to find out what happens if you wear it too long. So there you go, don't go trying to wear it for 2 weeks in a heatwave!!

My nurse also marked me and she had me sit and stand, bend. She felt all over, I took deep breaths. You can give input too but they know where it will fall and what is comfortable for their patients.
Posted 9/16/2015 5:39 PM (GMT 0)
The important thing is to have a WOC Nurse mark the area. They take into account where your waist is, movement, size and with the right nurse your clothing preference (low/high waistband). I was very under weight on my first one (spot has not changed with the others) and was marked as a 'just in case' which turned out to be emergency, so it was a life saver!

As you gain weight post surgery, your wafer may change once or twice, but the position should not be an issue if marked correctly. Other variables for wear time are more towards activity level and products you may use (less IS more!).

Good Luck and welcome to the forum!
Posted 9/17/2015 1:19 AM (GMT 0)
When I was in for my colectomy the nurse said "where do you want the stoma? " I said "here ". She put a dot on my belly and wheeled me away. No advice about comfort or anything. That was it. Worked out fine. Lucky me.

Dan
Posted 9/17/2015 4:57 AM (GMT 0)
I didn't get to pick a place for my stoma, I've mentioned that on another post somewhere here! Surgeon said he'd decide what woukd he best to prevent hernias and other problems for long term use. I'm 30 so I figured let the pro pick the best place that's actually in there! There's really not too many places they stick a stoma I do t think? Generally all in the same area around your waistline.
One thing you'll find as I have very early on that not all wafers are created equal. I got samples from every company that will give them and there's a few I threw right in the trash, wouldn't even waste my time trying them. Right now I'm sticking to the convetec moldable durahusive 2 piece system. I wear it for 5 days but feel like I could go much longer with the wafer, it's a very sticky wafer.
Like you and most people that have ibd I lost a lot of weight prior to surgery. Still haven't put close to what I need to back on. But I don't think a little weight will effect the wafers any. I do thint if you gain a lot of weight after surgery you can create other problems like increase chances of hernias among other problems.
Hope that helps, these products are pretty good though I think you'll find one with the help of your WOC Nurse that works well for you
Posted 9/19/2015 12:48 AM (GMT 0)
Good luck with the surgery. I had my sub total colectomy in dec. 2014. I had lost 65 lbs. in 3.5 months, and was quickly on my way off this planet. I can honestly say the only regret I have was not going permanent from the start.

At the time I couldn't imagine living with a bag so I wanted the J-pouch, but after having surgery and dealing with stoma for a few months I postponed my 2nd surgery, and after a year decided to just keep the ileo.

I change mine out every 4-5 days ( have gone 7 without problems before), but I had a couple breakdowns early on when I decided to not use a barrier ring, and dealing with skin issues is not worth pushing limits for me.
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