Posted 3/20/2016 7:35 PM (GMT 0)
Hi, it has taken me 3 months to the day out of surgery to get 3 days out of my appliances with a loop ileostomy.
Constant leaking under Eakin and to wafer.
I saw 2 nurses but ultimately figured it out on my own through google and other pics of what nurses and patients did.
My ileo distal opening is flush with the skin. Though "bm" opening is on top of stoma which sticks out about an inch and a half to 2 inches. If I had 1 hole perfect, but the distal (hole that constantly oozes mucous), is laying right on abdomen.
If I knew how to post pics of how I pave it so you could see it. I took them for my surgeon but on this site I don't know how to attach.
Okay, I never thought of paste to caulk but came across a post showing using paste on skin and ON outside of wafer to caulk spaces between wafer and stoma.
I got 3 days right out of surgery due to both openings being on top and stoma protruding perfectly. BUT, it healed with BM hole on top perfectly, stoma still protruding perfectly, BUT distal opening 2nd hole (MUOUS opening) flush with skin. Constant burning on skin non stop.
When problems started 6 weeks out of surgery I'd only get 12 hours, - 24 hours hours. I'd leak through wafer side, through Eakin seal, and burning, itching, changing, frustration, because I'd have to change active to stop leak and burning.
I use Convex wafer now.
1) I put ALCOHOL paste by Coloplast around whole stoma. I pave it. NO ALCOHOL paste stays soft so moves too much even after application.
- ALCOHOL paste dries harder like caulking. I pave under my flush area, so the mucus that comes out of distal opening at 6 o'clock flows directly on paste sidewalk pave
-I then pave all around WHOLE stoma regardless of the fact the top area is protruding. I pave thick, not too thick but it's not translucent thin pave around stoma, and about 3/4 inch wide all the way around. Right against the area where stoma meets abdomen skin.
2)I cut wafer to the size of my stoma almost snug with the area of stoma that sticks out until I reach the flush area. That area gets cut more of an area. I'll explain why below.
3)I attach a "thin not regular size" but "thin" Eakin seal around wafer hole I just cut.
-(I have a hole form I can cut to now from tracing a copy that worked, so that part is easy. I put Eakin seal a bit smaller in that, you can see edges of Eakin under wafer edge. That way as it expands it fits snug. I checked with the ET nurse on all points of my method she said fine.)
Remember that below area that is flush to skin, is now paved with paste that is hardening. It is paved right at the start of the slit on skin, and out about 3/4 of an inch, and then all the way around stoma base.
4) I now place on convex wafer with "thin" Eakin seal attached.
-With wafer on, it's snug all around except for bottom area that is open but looking down you can see it has been paved so don't see skin. I use ALCOHOL Coloplast paste again and literally pave all the way around my stoma where it meets the plastic wafer. Space or not, that area gets caulked.
***No feces can come through caulked area on the outside of wafer because it is caulked around stoma. It can't obviously penetrate the wafer, and it can't penetrate the 2nd layer of paste caulking on the skin around the stoma.
-The area at 6 oclock where there is more space between distal opening and wafer is like a ditch. I had to leave an opening so the mucous to come out. BUT remember, the skin is caulked and paved before I put the wafer on, and you can only see paste and then the slit. NO skin. I then recaulk that area in paving the side of inside edge of wafer by slit opening, it's like a driveway going down, down to the dip in 6 oclock by the slit leaving the opening open, but making sure there is no where for mucous or bm to go through anywhere else.
Hard to explain, I hope you understand.
It's like I'm an architect for this. Good lord right.
**I showed my ET nurse last appt. She was impressed and said it won't be hard on skin as alcohol in paste dries fast. We learned from each other. Initially I was using sealant spray, powder, tried barrier strips, rings, duo derm and more, and I still leaked.
Now using only paste to caulk around stoma on skin, and paste to caulk around stoma on wafer, and a thin Eakin seal on wafer, I get 3 days. Eventually the bm and mucus errodes the caulking. If not for the distal flush opening area, I'd get an easy 7 days this way.
Maybe this will help you, maybe not. Loops are a beach.
My ET nurse suggested I email my surgeon and say it healed so problematically, I will have trouble daily unless we can resolve until reverse. Meaning surgical revision. I figured it out so am okay though would much rather change a bag daily and wafer every 7. So much easier getting longer wafer time good lord. Loops are a pain to change so much and so active and output and on and on..........
Learning the new method I can now wear 2 products I thought didn't work on me when I initially tried the samples I got in the mail. Now, both Convatec Convex, or Mio Sensura Click Convex that you can wear horizontally to rotate, to wear stealth belt with, I can wear. I couldn't before, I'd leak.
Before new method, I leaked through both. Through everything, Hollister everything. I ordered tons of samples. Nurse said if you find a method, you may find you can wear one's you didn't think you could wear before but that is an IF you find a method.
She was right. I'm personally now, sticking to Mio Click so I can wear horizontally with stealth running and bandeaus when not running, to also not having it hang on my leg. Unwell to run now due to something else but when I can, the Mio which I can rotate horizontally is better for me for working out and clothes style I wear.
**For Mio Sensura Click wearers, I have to put coconut oil on the rim of both bag plastic rim and wafer rim, or it is too tight to rotate. That's for anyone that has problems turning it like I did. That fixed it for me. Q-tip and lube both rims and it turns no problem.
If my reverse doesn't work, I'll get an end. I really don't like loops.