Cutting the wafer to fit the new stoma

I only had surgery 2 weeks ago and my stoma is still shrinking. Had an accident tonight so I had to change the bag at midnight bc it was leaking around my belly button. I think it's bc I changed it the first time myself the other day and didn't get the sticky part all the way down near my belly button.

Anyhow, my question is- measuring the stoma- do you just do the part that bulges out- the stoma, or the surrounding tissue (still red and stuff from where they created the stoma. I guess what I'm saying is I'm only measuring the little part that sticks out and not the enstire thing that was created. So, I think the paste and hole may be too small, thus creating a pocket for leakage onto the wafer. Does this make sense?

The visiting nurse has helped me in the past but now I'm terrified I did it wrong, especially with it being midnight here and having to do it all on my own. I don't want the skin to get irritated or infected or whatever bc unmeasured wrong and poop is now sitting on the skin. It's giving me lots of anxiety- so much so I hate to go to sleep!

The visiting nurse still has to come this week - I'm thinking of calling tomorrow to see which day and making it sooner than later so I can have her take a look and see if I did it right.

I looked online for videos but most are of pouch changes for those eoth healed aromas- not ones that still have swelling from surgery. It's hard to tel if I doing it right.

Ostomy prep


STANDING POSITION IN FRONT OF SINK
CHECK LIST
- Hand mirror - Skin prep?
- Pouch - Blow dryer
- Wafer - Stoma powder?
- Sure seal - Tincture of Benzoin
- Q tips - Rubbing alcohol
- Few folds of toilet tissue - Warm, wet face cloth
- Paper towel - M-9 deodorant drops
- Zip lock bag - Few squares of gauze
- Ball point pen - Ostomy belt
Choose a time of day when the stoma is inactive. For me it’s the first thing in the morning.
I lay all of the above items out just like an operating-room nurse would do in the hospital. I don’t want to be hunting around for anything.
Prepare wafer. I cut hole to desired size. Remove release paper and heat gummy side for THREE seconds with blow dryer.
Prepare Sure Seal. Remove the release film on ONE side of seal and heat for THREE seconds with blow dryer.
Mate the wafer with the Sure Seal.
With forefinger, pull enough Sure Seal through the wafer hole to form a “turtle neck”.
Now place wafer aside.
Place a fold of toilet tissue on the leading edge of the sink and lean on it with my abdomen just in case there are any spills. I don’t step back from this leaning position until I am ready to apply my pouch.
Remove old wafer and pouch from abdomen and place in sink.
Place hand mirror in sink and adjust for viewing.
Clean skin around stoma with dry toilet tissue.
Continue to clean skin around stoma with alcohol until all residue is removed. BLOW DRY SKIN.
Keep your eyes on the mirror. No drips are allowed. If there is a drip of any kind dab with gauze. BLOW DRY! BLOW DRY!
Using a Q-tip apply a coating of Tincture of Benzoin to surrounding skin. BLOW DRY.
Keep watching the mirror for drips.
Apply a second coating of Tincture of Benzoin to skin. BLOW DRY.
Now heat the wafer and pouch that you’ve already prepared with blow dryer. THREE seconds is enough.
Place wafer over stoma and remove release paper.
Use M-9 if available.
Close end of pouch and done! 7 days guaranteed. It’s important for the wafer to stay in position for at least 5-6 days to allow the skin to heal and to allow the adhesive to break down naturally.
RAW SKIN is another matter. I would not use alcohol on raw skin because of the burning sensation. In the case of raw skin I would use a skin prep such as non-sting Nephew & Son. Somehow, someway, it is important to get the skin squeaky clean.
And then, I would continue with the directions using the Tincture of Benzoin. If skin is raw the Benzoin will sting, but it’s worth the few minutes of discomfort.
The Benzoin is anti-septic and provides a very sticky base for the wafer.

Tom1-
Thanks. I'm not too familiar with those products, but I will look into them. Part of my prob is I can't seem to figure out how big to make the cut. I never thought to use the blow dryer. I use the heating pad to warm up the wafer to make it easier to cut.

My main prob this am was the stoma kept leaking. Just when I'd get it clean it would ooze more. Then I started crying and it came out more.

Is it easier to stand? I've been sitting. Also, my nurse said just to use water and a wash cloth, no rubbing alcohol and stuff. Did they tell u that's ok or did u figure that out yourself?

Cupcakes-
my nurse suggested that today. I just ordered them - both the adhesive strips and the barrier rings to see which is better. No idea if my insurance will cover both but I'll see. I'm glad it works for u. Is your ileostomy permanent?

You may need a convex wafer since you said you were worried about the stoma being short. It's worth trying if you're having trouble. I think you need to chill out, relax, and just do your best to take control of it. I was really great with my end, but the loop is a challenge. As much as you can try to take control, if yours is anything like mine, it's going to be frustrating, and there's nothing much you can do. Do your best to get a good hold on it, it's only a few weeks... The convatec moldable wafers can be good for sizing. You just mold it open and it sort of fits to the stoma. The adhesive on those used to hurt me to remove, get a good adhesive remover if you're going to try those. Also I used to use a one piece often with my loop since nothing lasted. I just gave into changing every 20 hours or so with my loop. I couldn't get it to last any longer than that. Huge difference between that and the 7 days I coudl get with the wafer on my end. It's probably not you, even though you're brand new and you WILL improve, those loops are difficult.

The nurse came here today and helped me - she watched me change the bag myself and it went beautifully! It helped that I hadn't eaten and it wasn't oozing the whole time.

My latest challenge - I just emptied and scratched a hole
In the bottom near the fold/Velcro part. Dang it! I was just feeling a little bit more confident in changing it and that I had the "leak" under control. So I put some waterproof tape on it and I'm hoping it'll stay. I'm not confident it will.

I also only have 2 bags left. My refill order won't be in until tomorrow at thre earliest (Thursday) and the following day (Friday) more likely. Have any of u run out of bags? What did u do?

I have insurance and they have a 24 hour nurse I can call. And if need be, they can come out and help me chnage the bag, etc. but idk how they could help me if I'm out of bags!

I've done the very same thing several times with my nails on the bags. I use a two piece, so I just changed out the bag.

Do you use a two piece? If you do, if necessary you can just reuse the bags if they're still in good shape.

I sit on the toilet facing backward. I have all my supplies lined up on the toilet tank. I lean forward so if there is any spillage, it just drops in the toilet. I have also cut 1 inch strips of paper towels and wrap around my stoma like a hat to catch any spillage. I usually have several strips in case one gets dirty, I just throw it away and put another one on.