Need Help with Stoma Appliance for Unique Placement

I'm the caregiver for my mom who is 92 and just had surgery 2 weeks ago. Her stoma is super close to her navel (which is an inward one) on her right side, plus she has stomach creases.

We've tried several different bags and none work because in the navel area it just won't stick due to the indentations. It leaves a big gap and then leads to major leaks.

I'm so very frustrated and stressed out. Any info on how to deal with this kind of situation would be appreciated.

We've only tried the one-piece ones so far because that's what was recommended to us when leaving the hospital.

Thank you for any help.

You may want to try the convex pouches. You can call the different suppliers and get free samples. They are all happy to send free supplies in hopes of getting your business. I would also recommend a ring too. Two weeks since surgery so there will probably be changes in the size of the stoma. If leaking is occurring, let the ostomy nurse know. You may need to go to the two-price system.

Hi Cla, you do have a job on your hands but God bless you for being there.

Two or three things to help, really help!!

1. Eakin Seals. The four-inch seal with a hole in the middle. The material is soft and pliable, it can be molded and shaped to fit and fill any creases. There is a cream version but it's very messy and awkward to use. The seal/washer/pad goes on the belly first and squeeze it down on the inside edges.

2. I use the Hollister One Piece Convex Wafer. Mine has a stiff plastic outside layer which curves into the stoma, Convex Wafer. This pushes the edges of the circular hole and the Eakin Seal right down into the stoma edges. This will stop output from getting under the wafer.

3. Micropore Surgical Tape made by 3M, only this, 3M will work. I use 2-inch tape on the four sides of the wafer. This is very thin tape so the strip along the navel side will stick tight enough to seal the navel area.

4. One more thing you really need is something called "Pearls" (or Absorbagel). It's a salt-like powder that comes in little packets. Every time the bag is emptied, pop one of these into the bag. This will absorb much of the liquid in the bag and the thicker the output is in the bag, the less likely you will have a leak. It works fantastically. The patient will get much better sleep also.

This is what works flawlessly for me, should for any ileostomy. I have a large midline scar and the tape works wonders.

All the best, and stay safe from Covid.

Eamon.

Perfect for us high output ileostomy.

Thank you very much ... very helpful information. Anything helps at this point.

Staying Hydrated with an Ostomy with LeeAnne Hayden | Hollister

Typing on my phone again!! "You have a job on your hands..." ;Not a kob!! Have to get some new goggles!!

I had such a hard time and so many leaks before I found those four very helpful items. If you are taking a long flight or a long car trip, train etc. you really need the gel packs, pearls (USA) or Absorbagel (only in Canada or Europe). Instead of five or six bathroom visits, you will have one or two!! And much less risk of leaks. The liquid has lots of stomach acid which will dissolve the sticky part of the pad. The gel makes it thicker and much safer.

All the best, Eamon.

Magoo... I have pearls but was always afraid to try them. I fly to Virginia next week... I think I will try them as I have a window seat this time instead of an aisle.
Thanks for the suggestion, Ritz

I bought the gel and I'm looking to get the 4" rings! I'm so hoping I can find a solution! Today alone I had to change the bag twice! It's just so frustrating! Thank you very much for your help.

Cla... Is your mom in a convex appliance! The ring under it will help tremendously.

Hi Ritz, I definitely recommend using Pearls. If you are getting a lot of liquid, you can even try 2 at a time. These packets are bigger than Absorbagel but not quite as good. Try one at night before you go. If still very liquid, use 2 the next night. This will allow you to gauge how much you need... It goes in every time you empty.

Once you try it, you will wonder how you got by without them!!

Eamon

Hi Cla, you can find them on Amazon and if you have to buy them, you get a better price. Get your doc to prescribe them, insurance??

Stay safe. Eamon.

That's right Ritz. The Hollister one piece I use has a convex hard plastic backing, the plastic backing is the key. Some just have the flexible wafer with no hard plastic pad, these are no good.

I put up some pics of these items in my Photos. Cla should have a look at the pics.

Xx

Magoo... Cla may need some powder and adhesion also under the ring. One cannot just lay it on... it needs a bit of pressing on dry skin.
Ritz

Yes, Mom has Medicare and insurance. Thank you for all your help!

That's great Cla!! If one of the pearls is not enough, try more than one. If you try these things, life will get a bit more comfy for all involved. It can be a bit traumatizing if the patient thinks they are making your life difficult, so your mom will feel much better if the bag/ostomy problems are minimized. She won't think that she is being a burden on you.

I really hope things get a bit easier for you both.

Love and hugs from Sunny Cal, Eamon.

Hi Ritz, about the ring, 4 inches, sticking to skin. If you have a sunny windowsill in the bathroom, just leave the ring in the sun for a few minutes, near a radiator or just at room temperature if it's warm inside. The ring will quickly become more soft and flexible. The softer and warmer the ring (Eakin Seal) is, the better it will stick, even on damp skin. I've never used any kind of adhesive with the Eakin rings. Actually, I sometimes get the placement a little off and I have to lift it and move slightly. I find it hard to lift it off once it goes down on the skin. I did mention pressing the edges down... Very carefully and gently, but once it's down, the heat from your skin/body will soften it and sort of melt the edges around the stoma to fill in scarred areas. I have scars just beside the ostomy hole, the central scar has been opened maybe 6 or 7 times in surgery, so the area is a bit ragged. Sometimes, if I'm really having a hard time, I will use a 2-inch Eakin Seal first, around the stoma. These are a bit more dense and less flexible but longer lasting. Then I put the 4-inch Eakin on top of that and finally the wafer on top of that. I was cutting some oak trees with my brother on his property, climbing a hill and climbing a bit on trees in 100-degree temps. The heat was melting the 4-inch ring and causing leaks. I used the 2-inch ring first with the 4-inch on top and it was amazing, no leaks. The 4-inch and the 2-inch sort of melt into each other, so for 2 inches around the stoma, you have twice the protection where the creases are in the skin. Works like a dream for me.

Eamon XX

Magoo... I think I'll try that. I need to change every other day and I'm in Arizona... it's hotter than hot. Thanks for the information... always helpful, Ritz Cathi

I have a flat stoma on the surface of my skin with a dip as if he stitched it. So mine is not only flat but in a hole. Finally, after 4 months of using every free sample, I found what works for me. My stoma is just left of my belly button and at times I have to slice the wafer to go down. Ok, so I use the Rings? I rip it in half and roll it into a long noodle. Then I take my 2-piece click from Coloplast and put the ring around the hole I cut in the wafer. I don't put it right on the edge because the ring, once moistened, grows and seals. The 2-piece is great because my hole is the size of my pinky, so this makes it easier to see where it is at. Also, I can position it a bit to one side to avoid the belly button area and not have to cut it. If the ring swells too much, all I have to do is click off the bag and pull some out without having to change my Coloplast Convex wafer. Before, I was leaking through two to three bags a day. I now have to say, "HEY, it's been 5 days, maybe you should change it." Also, I stopped using any adhesive spray-type things as my rep said Coloplast is made to stick and does better on its own. Hope this helps.

Wow, thank you!

I just today said I'd like to try the Click 2 Piece!
All you guys have made me feel so much better!

Still having leaking issues and now she has a horrible rash. I've called her doctor and hospital social worker to seek help with an ostomy nurse, and I haven't gotten any responses yet ... at my wits' end with worry.

You're amazing and so is your mom. Let's see if we can give you both a little more help. Definitely keep on the doctor/ostomy nurse to get a visit.

Often convex pouches need a little extra support to do their job. You might try having your mom wear a pouch support belt that attaches to the belt loop tabs on the pouch. Coloplast, Hollister, and Convatec all make their own pouch support belt for this and will send you samples if you call and ask for them. Sometimes this belt is the difference between failure of a convex pouch and success. You always have to be sure that the belt is loose enough that you can fit two fingers underneath.

If you keep having issues getting through to the doctor, try whatever other options you have. Primary care physician, urgent care, etc. Or, some of the ostomy companies, such as Convatec, are offering online zoom ostomy nurse assessments.

Wishing you both the best.

If you do use a belt, like MB T suggested, make sure that it's not too tight nor that it is pressing too hard on the bladder or it won't be her bag leaking, it'll be uncontrollable urine leaking all over the place.

You know, I am currently going through a similar situation. In fact, I have to see my surgeon on the 29th for it. I have had my ostomy since Oct 2018. Up until the last 4 or 5 months, I have had no problems with a bag fitting me. But earlier in the year, I had lost some weight due to an iron and potassium problem. So, I think my stoma got smaller. But for a while now, I cannot seem to get the bag to stay on for more than a few hours without either leaking or completely coming off. I have a hernia, but a bag fitting was no problem until recently. I have gone to see my Ostomy nurse at least 4 times, and still no answers. I have been told to wear the Sensura flip one by 3 different nurses. It is supposed to flex with my hernia, but still keeps leaking. I have to see my surgeon because I read if you are having problems with it staying on when you have a hernia, surgery may be what is needed.

So, I would contact the Ostomy nurse or have an appointment with her surgeon. Surgery may be what is needed. Good luck and let me know how it goes.