Posted 10/22/2014 5:42 AM (GMT 0)
Everything you said makes perfect sense. I'm sorry for all that you've been through, but as others have said things will get better.
Getting used to the stoma can take a lot of time, but it will happen. I know it's gross and icky and weird, but eventually it will just be another part of you. I NEVER touched mine in the 7 months I had one, except for some quick dabbing with a damp paper towel to clean up during a change, but I did get used to looking at it. It's something you're just going to have to do.
Hopefully the home nurse that visited you today knew what they were doing and gave you some great tips and hooked you up with a lot of samples. You can always call any of the manufacturers and explain to them your problems and their customer service reps (who I always found were extremely helpful and kind which was reassuring given the subject matter) should be able to offer you product suggestions as well as send you tons of samples.
Not sure of your location but the big ones in the US are Hollister, Coloplast, and ConvaTec.
I know the awful feeling of the skin being raw and sore. The good news is that if you can get a good seal, even for 2 or 3 days, it should start healing dramatically.
Do you have a loop/diverting ileostomy or an end ileo? Basically, how much of it is sticking out? If it's not protruding very much, or flush with the skin you might benefit from a convex wafer which will help push the ileo out more and keep the output from getting under the wafer, which could be a major cause of the leaks.
Powders can work great to heal the skin, but you want to make sure you use VERY LITTLE - less than you think, and wipe off ALL of the excess after it absorbs as it can actually cause issues with getting a good seal. I used stoma paste for some time to help with the seal, but I wouldn't recommend it for you right now as it contains alcohol and can burn like hell on the raw skin. A barrier ring can help - they are essentially the same as paste, just already come in molds and don't contain the alcohol.
When you're applying the wafer make sure the ENTIRE area is as DRY as possible. Don't use soap or lotions around the area when you're changing the wafer as they can leave residue and again, mess with the seal. Just wiping the area with water and a paper towel is sufficient and I can't stress a enough - allow it to fully dry.
I know you said you've lost a lot of weight since surgery, but is the ileostomy located somewhere in or around any skin folds? I was severely underweight going into my surgeries so I can't be much help here if there is, other than to say that I always applied my new wafer either lying down fully stretched out or standing with the skin around the ileo stretched a little taught. Afterwards, just cupping your hand over the new appliance can help warm and activate the glue a little and get a good stick.
And as watermaster suggested, ostomy belts can be a big help - it will keep it firmly pressed up against your belly. I never used one, and have heard they can be uncomfortable, but also a big help.
Unfortunately it may be a long trial and error period as some peoples skin just doesn't agree with certain products and they just don't work as well as they're supposed to.
The output should thicken up overtime, however, if you DO have a diverting ileo it might not. With mine, oatmeal (with less water than recommended) and a banana in the morning for breakfast always kept things relatively thick throughout the day, and only a few sips of water for the first hour or so that I was awake. I also snacked on a lot of potato chips and pretzels which usually helped as well.
Other typical thickeners are rice and pasta, but neither ever really helped me. Mashed or baked potatoes were always helpful. Basically any starch.
It's still relatively soon after your surgery so I would stick to foods that are low residue and chew more than you think is natural.
Never be afraid or feel bad about asking any questions you might have - either here, or to a doctor or nurse. Things really will start getting better once you get the hang of things and the trauma of it all starts to become more bearable. Just be patient with yourself and take everything one step at a time.