Using Stoma Paste and Changing My Bag on My Own

2-part question here..

A few weeks ago, I developed a hernia around my stoma. My surgeon looked at it and said he wasn't surprised, but said he'll address it and fix it in February when I have my reversal done.

I tried a new type of bag from AdeptHealth that the rep said would fit better. It doesn't, and it caused a rash on the skin where it attaches. The surgery nurse said to try stoma paste to help it stay put, and I've had some success with it, not complete, but I'm learning..

Anyone else having issues with keeping their bag attached? The hernia bulge around my stoma certainly doesn't help the bag adhesive to stay stuck to my skin.

Also.. my wife has been assisting me in changing my bags out. Mainly because I can't see the stoma too well and judge its size even in the mirror.

I take the bag off myself, clean around it, and she takes the stoma size indicator pattern to judge the size of my stoma and cuts a hole in the bag to fit it. She does this as I'm laying flat on the bed as it's easier. The whole process takes just a few minutes at most, but I wonder if there are others on here that change their own bag on their own and if so, how did you learn to do it? I want to be able to do it on my own and not rely on anyone.

Hi e,

Can't comment on the adhesion thing other than to say the barriers can't work miracles. If your skin is very uneven, it will be hard for even stoma paste to make things level... and stay that way. You didn't mention how often you change your bag, but if you're getting a few days before changes, you might want to try changing it a day sooner. If you're getting leaks right away... forget I said that.

As for changing things yourself... just make a template of your stoma size and then pre-cut your bags (I assume you're using one-piece bag/barriers). You can use anything to make a template, then once you have it, just reuse it to trace your stoma outline on your new barrier and cut. Then you can give wifey a break!

;O)

I can't make recommendations on the first question as I'm still sorting things out myself.

For the second part, I do my changes myself. My husband helped with the first one, but he really just handed me stuff.

I take mine off in the shower, I do my hair with it on (because I use a lot of products), then take the bag off with some adhesive remover and put it in the doggy poo bag I set up before I got in. I use the shower to wash around my stoma thoroughly, and use a washcloth for things the water pressure won't remove. I am careful to clean under the stoma (where I can't see in the shower) with the washcloth, because I missed some in the past.

After I get out of the shower, I dab dry with a towel, then measure. My stoma has been reliably 31mm the past three changes, so I start there. Alternatively, I cut my wafer a little narrower than I expect, peel off the plastic, and see if it fits. If it's too small, I cut the wafer a teeny bit more (I did this when I didn't have a guide). I use the mirror in the bathroom to do this.

I apply my barrier spray and dry it with the hair dryer on cool. I also use the hair dryer (on a warmer setting) to warm my wafer. I then dry it with the hair dryer again, because I think I've not gotten it totally dry in the past. Then I apply my appliance, pressing first around the stoma and working my way out. I use the hair dryer on warm for a minute or so to help with the adhesion.

I use the bathroom mirror a lot.

Both answers above are good. I will add that I use a stand mirror on the bathroom counter for a closer view. Just be sure you are completely dry. Some people sit, but I stand to place my bag.

Oh yes - I stand, I even kind of arch my back a little and “stretch out” my stomach skin; it helps prevent wrinkling around the edges of the wafer.

Words of Encouragement from Ostomy Advocates I Hollister

In regards to adhesion, are you attaching to clean, dry skin? Secondly, are you warming the wafer either before or after application? I use a hair dryer on low to both help dry my skin after my shower and to warm the wafer before application. The warmer appliance will adhere better.

In regards to self-application, it's a matter of what suits you best. Some do it standing, some sitting, and some lying down. I prefer standing in front of my bathroom mirror, as I have a problem with both eyesight and flexibility. I normally empty and thoroughly flush my bag before I start. This makes the initial cleanup much easier. I stand in front of the mirror with a bucket underneath me to catch any wayward shit. Then, the appliance is removed and put into one of the plastic bags that come with my bags. I then use 3-5 flushable wipes to clean the stoma area. The wipes go into the bag. I then use an adhesive removing wipe to get as much of any lingering adhesive. Next comes the shower, where I thoroughly clean the skin around my stoma. I use Dial anti-bacterial soap for around the stoma.

After the shower, I make sure things are thoroughly dry. After toweling off, I use one Kleenex Hand Towel to dry around my stoma. They're a little expensive and have only 60 to a box. But since I change appliances once a week, they last more than a year. After drying, I first use the blow dryer to put the finishing touch on my skin. I then remove the seal around the flange, apply a barrier ring, warm the whole thing up, slap it on, remove the paper from the outer seal, make sure it looks good, and then apply the pouch.

I should say that I use a pre-cut convex wafer. My stoma is pretty stable at just under an inch, so pre-cuts make sense, especially with the barrier ring. I also find that the flange adhesive on the Hollister Adapt pre-cuts is much better than the non-cut wafers. I have an ileostomy, and you have a colostomy. I am not sure how long it takes for a colostomy stoma to find its optimal size. :-)

Anyway, I hope this helps.

Daniel

My wife helps me with mine also. If you go to a two-piece bag (pouch), it will be easy for you to put it on. It sounds like you are using stoma paste rather than a barrier ring. The barrier ring might fit better since you can get thick ones that you can mold to fit, etc. You can also use some of the stoma paste if you can't get it to fit properly because of the hernia. If you should try the barrier rings, I attach mine to my bag first and then put it over the stoma. Just prior to attaching to my skin, I warm the ring with a hair dryer, which helps with it sticking to the skin.