Alternative Positions for Ring and Flange Application?

Does everyone do this lying down? Just wondering if others do it another way. It was the way I learned in the hospital. I have a colostomy.

No, I find it much easier standing, over the toilet. I once managed it sitting, after a problem in the car, but don't plan to repeat the attempt!

Mostly standing, but occasionally sitting!

Standing over the toilet, my ileo would be like a geyser if I tried to do it while lying down.

Yeah, I do it standing. Can't imagine doing it sitting. Unless you have a really flat stomach.

Living with Your Ostomy | Hollister

Lying down? I would never have thought of doing it that way. But then I'm always worried about output ruining the party... so I do mine standing over a sink, with one of those brownish-grey plastic bags that come with the Hollister bags tucked into my shorts as a bib in case I have output. Guess it depends on how sure you are you won't be having any output while changing. Lying down, eh?

Funny how we all assume everyone does what we do when there are a myriad of ways to do just about everything.

Regards,

Bob

Like Bob, I do what I can to do my changes first thing in the morning when The Leach (my nickname) is sleeping. Even then, I have to work pretty efficiently to get my rig on before the party is crashed. I do my standing up as well, but then I move to the bed for 15 minutes to press the rig to my abdomen to ensure that I get a good melt/seal.

I'd do the whole operation in the shower if I could, but I lack counter space nearby to hold all the powders, wipes, stomahesive (I put it in a syringe so I can apply it in as small amounts as I choose), karaya rings (which need to be trimmed), flange, and pouch. That way, if I do have a movement, I'm right there to rinse and I can easily wash the goo down the drain.

Dave

Standing up mostly on bad days, sitting down... there's no right or wrong way, just what's right for you.

Standing for me and never first thing in the morning. A lot of people say that is when their stoma is least active, not the case for me! If I try to change it first thing in the morning, it is an absolute nightmare!

Well, if we're now discussing the best time to change the ring and wafer... for me... evening works best. I use my laundry tub, which has a sprayer. Set it to warm water. Rinse everything, poo-wise, down the drain. Not that any poo comes out. It just cleans the area safer.

I have a colostomy. My output is very thick. I sit on the commode and remove the bag and clean the wafer with TP. Then I stand over the commode and push out what I can. Then I use a sprayer to clean the bag. Once in a while, I have output when cleaning the bag, but I stand close enough to the commode for it to go in the commode. I have had a few accidents when output is not thick, like when I have to take a laxative. Sometimes, if there is not much output, I sit on the commode and open the bottom of the bag and let it empty, then squirt some water in from the bottom opening. I roll up the end of the bag and squish the water around, then empty that out.

Hyperactive ileo here. I have to stand in the tub in case I have output.

Standing, but be sure to stretch the skin while putting the flange on for better adhesion and to avoid the tugging sensation.

I do mine sitting laid back, never tried it standing because I always had issues lining it up without a mirror to see the underside of the stoma. I had issues of skin being exposed. I manage this by eating an early dinner and sleeping at night, drinking water when I get up to empty the bag during the night. This moves things through, and by 3, I slow my intake of fluids. Around 6 in the morning, I will shower to remove the flange and extra glue and use a piece of paper towel to cover the stoma if it decides to have a mind of its own, but it is normally quiet and slow in the morning. At that point, I change everything out. I guess it is my peaceful time that I have, letting the skin breathe as I prep it for putting on the new appliance.

I stand in the bathroom against the sink... in case of a poo run, I double up plastic shopping bags and put them in the sink, which is also handy for discarding old bag flange, etc. Then, I use the mirror to make sure the flange is in the right place... after all is done, I tie the shopping bags up and Lysol wipe the sink area.

Angela

I usually attach my barrier bag laying on my back - my husband puts the liquid glue around the stoma, then I fan to get it kinda tacky - then he applies the barrier bag. It seems to go on easy without any wrinkles in the barrier. If I apply it myself, I apply it standing up. Do what is best for you!!

Mark.. I'm not sure stretching skin like you said works for me standing up.. haven't tried it but would think before applying the flange the skin should be at rest. I find at rest better, but later it does pull. Not fun. So you think your method would prevent stretch issues later? Or did you mean to stretch the flange instead? Thanks. Tony.

My WOCN taught me to stretch the skin to prevent pulling the adhesive away. It makes a big difference for me. I always get more wear out of the appliance when I get this right.  

Hey guys,

I was taught laying down and using a mirror when in the hospital. That did not work well at home. It is a long way to the bathroom from the bed and I am not laying on the cold bathroom floor! Lol

I change everything standing up. I irrigate so I do it after irrigation. I shower with no pouch and then stand at the bathroom sink and work from there. Never any output then.
One day, it is going to get me because I forget and start walking around the house to get a cup of coffee or let the dog out and suddenly remember I better go get a new flange and pouch. Always mid-morning. Whenever I get there. Only change every 10 days!

Puppyluv

Puppyluv, I watched a video of a man changing, and he had a mat laid on the floor in the bathroom. That is not for me either. LOL

So many different techniques. I use a one-piece drainable that lasts me about 3-4 days. I usually change it in the morning. I prefer to stand over the sink. I put down about 4 squares of toilet paper folded to catch any output. I basically press my abdomen against the sink so that when I wash the peristomal skin, all the soap and water can drain into the sink and not all over my crotch. This works well as the sink is about an inch below where the bottom portion of the wafer rests.

I can usually time putting the new pouch on without issue. I've only had an issue with output squirting all over the adhesive side of the wafer once or twice. And most of the time, if I have output when removing the old pouch, it just ends up in the sink. After the new pouch is in place, I toss the tissue in the toilet, hose down the sink with a Clorox wipe, and throw the old pouch in the garbage.

It's a basin-style sink so no countertop. And I'm lucky as I don't have needs for sprays, pastes, or adhesive remover. I just get a washcloth, nice and soapy, push between my peristomal skin and the wafer, and it basically peels right off, no adhesive remover required, no irritated skin. I lay the old pouch on the closed toilet lid, use tissue to get most of the crap off of my stoma, and then I wash the peristomal skin and the stoma. Sometimes you got to get up under the edge of the stoma as crap likes to hang out there. I then rinse the washcloth of soap, use the same washcloth to wipe the soap off of my skin and stoma, fold some tissue and wrap up the stoma so I can blot dry the peristomal skin with a towel. Once the skin is dry, I apply a skin barrier, blow it dry until it's not tacky, and then put on the new wafer.

Usually only takes me about 10 minutes from removal to cleanup. And usually right after a shower.

Bain

Ahhhh............you must be the guy the Ostomy Nurse who first showed me how to change my barrier in the hospital was talking about. She said to change my barrier I just take off the old, clear it up and slap on a new barrier.......easy peasy. Well, it's not exactly that peasy for me, but I'm actually glad someone has it that easy, as it gives me a goal to shoot for. Thanks for the description Bain, I just knew that nurse had to be talking about a real person!!

Rock on my man!

Regards,

Bob

Stretch which way. Do you pull it up or down? You can only stretch one way, you do not have three hands.

I do not "stretch" my skin. Because the outermost part of the flange is at my waistline. I just kinda lay a flat hand above my waist and press up a little not to stretch the skin but make sure there are no dips and valleys where the flange is going. Makes the skin smooth which gives a much better seal. If you put it on over a line in your skin, it is a sure bet it will leak! I use cut-to-fit and my stoma has gone to an oval shape so I cut the flange using the resting position. If I were to stretch my skin, the stoma would change shape and it would not fit then either. It is an art to get the thing on cause there is no redo! Lol

Puppyluv

No problem, Bob. I've only had 24 years of practice. LOL.

Bain

I am a urostomy person (bladder cancer). I realize bowel contents make things different. But I do my change standing in front of a long dressing mirror on the back of my bathroom door. Can not imagine trying to do this laying down. ..... couldn't see over my breasts!! How do you hold a mirror and apply things??
I remove old. Wash with only a wet facecloth. I was taught NO SOAP as no matter how you rinse there is residual and then things don't stick. I then pat dry with a second facecloth and blow dryer with a hair dryer. Then it's the mini race to get the new bag on before the next dribble of pee...... and if that happens. Out come the wet facecloth and dryer again. I'm only 8 months into this so it's still a learning curve for me. My stoma is so close to my incision I have puckering along that side. So yes, I pull my skin tight on that side. I also have to cut a bit of my flange off or it would cover over my belly button. And not last long.
Hollister has just told me no more facecloths because of residual soap from washing them in the laundry.
I'm just recovering from a month-long broken skin issue. You know the bleeding.... the flange ripping skin off as you remove it. But happy to say I believe I've conquered this round

So good to read others' issues and troubleshooting ideas.
Sharon

Alberta, Canada