In home care nurse/bag change

So, this morning the in home nurse lady came to assist with my first at home bag change. I felt like I could do it fine on my own, but figured having someone here the first time wouldn't hurt either. Of course she insisted I let someone come back once more, just for the extra support...and I agreed to that, but am now thinking I might cancel and just handle it on my own.

I guess she was helpful, but also made me more nervous than I would have been on my own...mostly because of her personality...kind of dramatic and alarmist. Also, I'm now thinking about changing the bag again because I am unsure about where she had me place it....or I'm just being paranoid. Not to mention, she mashed so hard to make sure everything was sticking, that I am in more pain now than I have been in days....UGH! Anyway...

The real problem is, my large incision has a big silverlon patch over it that is close to my stoma and pretty much overlaps where part of the bag needs to stick. In the hospital we got it situated in just the right way to avoid the wafer going up over the bandage....the in home care nurse did not do this. Now the wafer is partially up on the edge of the bandaged area, which makes me worry that it can't be keeping good solid contact with my skin if it is having to raise up to stick to the bandaged area. If I change the bag and offset the cut to the very edge of the opening, I'm pretty sure I can replicate the way we had it when I got out of the hospital. If I try to do this and am successful, I really don't see the point in paying for another in home care visit. And...I could get a shower without the bag on while I did it!!

Anyway....this was a long post that really didn't say much of anything. Guess I'm just looking for some opinions and input. Does it sound like the bag will be fine if I just let it be, or is it worth trying to change? Is another in home care visit really necessary or do most people not do them? Thanks for any support and helping ease my worries!!

Post Edited (UCwhat?) : 3/21/2013 9:05:10 AM (GMT-6)

Agree, if you feel you don't need the home care nurse, you don't have to accept the visit. You rarely get a real live WOCN visiting you and sometimes the people who come will know less than you do already about ostomy care (sad but true).

What kind of wafer are you using? Is it the tape that is near your incision or the wafer itself (some wafers are tapeless though)? I was really paranoid about the tape in the beginning but most people find that the tape isn't very necessary. Often by the time I change my appliance the tape is peeling up at the edges and is barely stuck to my skin, but the wafer adhesive itself is still going strong. You can cut off the part of the tape that is near your incision before affixing it, if it is indeed the tape that's causing your problem. Wish I could explain this better.

A similar thing happened to me, actually... the only time I've changed a wafer really quickly (less than 24 hours later) was when the home care nurse 'helped' me with my first change and I could tell it was wrong. Trust your instincts. You shouldn't be in the habit of changing too often but if you don't like the way it's done, don't suffer through it, do it right!

I still can't decide whether to change this darn pouch or not....maybe I'll email my ostomy nurse? There hasn't been very much blood yet today...but I'm still unsure about the seal on the wafer and it maybe being too tight in spots....or I worry too much

Thanks, Liz....you are great!! :) I was told to change every 3 to 5 days. My output has been good, no pain or itching other than what I have from the incisions and surgical stuff. And now that the blood I was seeing seems to have eased up I feel a bit better....so yeah, you are probably right that I can just wait. The plan was to change the pouch again on Monday, when the next in home care nurse comes....but I might try and do it myself on Saturday or Sunday, and if it goes well just cancel the nursing visit.

Thanks for being so helpful and awesome!! Hope you are feeling well :)