Appliance Assistance Needed

Hey folks. I've been dealing with a specific issue for several months now and was hoping to find some helpful suggestions here.

I've had my ileostomy for five years. Over time the stoma has shifted slightly so that the intestinal opening is not top center, but down on the right almost directly against my skin. That's where the stool comes out. I recently saw a surgeon at Mayo in Jacksonville (where I had my total proctocolectomy done) and he believed that this was a normal occurrence. The issue is that because the stool comes out so low and close to the skin, I'm having trouble finding an appliance that stays on for more than 24hrs without leaking.

I used to use a flat two piece system with barrier rings that worked phenomenally. I could go a week without an appliance change. I can't wear the barrier rings any more because the thickness of the ring covers my stoma opening, resulting in insta-leaks. I've tried some convex systems, but all of them are way too deep a convexity for me, and they end up causing skin ulcerations or just popping off my body entirely.

Anyway, hopefully one of you gurus will have some knowledge to drop on me. If you have any specific questions that I didn't touch on, feel free to ask. I just want to be able to wear a bag for at LEAST three days again.

I don't have much advice but another way to keep a good seal is using a microwaveable heating pad or bed buddy. I was having leak issues out one side where my scar was uneven. When I heat up the bed buddy for 40 seconds just to warm but not hot and hold against my appliance for 3-5 minutes to really heat up and seal things I dont have leaks.

What appliance are you using?

Cmfdrama:
Be advised that "stomadhesive paste" is NOT an adhesive as word implies. Stomadhesive paste is a misnomer. It will NIT add tackiness or stickiness to the binding of a wafer to the skin as would Elmerms Glue or Scotch Tape.

Paste is meant to fill divots and creases in the skin to make a level skin surface for the application of a wafer. Think of it as grout used between tiles to make a smooth counter surface. Using a ring of paste around the cut-out circle of the wafer will often cause leaks because liquid ileostomy output will either seep through the paste or will undermine the paste.

A common saying among long-term ostomates is "Paste is a waste."

Even in the case of divots, creases, or irregularities in the skin, a better filler is found by using a small triangle-shape or thin strip of a barrier riding (ex. Ekin Seal by ConvaTecn or Adaptic barrier ring from Coloplast, as examples).

Deryleon: Have you tried a one-piece system with a highly flexible wafer?

I have an ileostomy that is fairly flush to the skin. The elastic polymer wafer of the Coloplasr Mio has been highly successful for me. I also use the CyMed one-piece Microskin wafer. Both the Coloplast Mio and the CyMed Microakon adhere intimately with the skin. The adhesion quality of both the Mio and the Microskin is second to none. I have a leak in inky the most rare of occasions.

www.ostomycymed.com

Like you, I tried a slew of convex and 2piece wafers to little avail. What came to work best for me is a wafer that is thin, pliable, flexible water that conformed intimately to the topography of my skin. The Coloplasr Mio and CyMed Microskin answered my prayers. Hopefully they will be just what you need, as well.