If you are relatively new to all of this, get to your ostomy nurse and get advice. They are trained in wound care.
2. If you've been dealing with this for a while and don't think there is anything a medical professional needs to check out, then here are the things which have worked for me.
a. Change the pouch as soon as you see leakage under the pectin wafer. I was waiting until leaking started around the outer rim of the pouch. This was too late. The poop that would leak under the ring itself was irritating my skin. This corrected a lot of my skin problems but not all.
b. Change to Cymed micro skin pouches with microderm plus washers. I just use the regular washers now, but when I kept getting sores, the plus washers (pectin wafers) have an anti-bacterial agent which helps to fight infection.
I also used special skin wipes which did not sting before applying the stoma powder.
I don't remember their name since I haven't needed them in a year, but they were truly invented by a genius who understood us. I'll post the name of the wipes tomorrow.
c. When I am changing a bag (usually every 4 - 5 days) I clean with water only. If I see any spot on my skin anywhere my pouch sticks to my skin, I use a q-tip and swab Mercuroclear over the area, and blow everything dry with a cool hair dryer before reapplying a new pouch.
I get Mercuroclear at Walmart (big box store). It is like mercurochrome but it is clear. It doesn't sting at all. I haven't ever noticed that it has any negative effect on the next bag sticking better or worse.
d. Having a 2nd colostomy when the 1st closed up: The surgeon spent 5 hours removing scar tissue from the old one. The new stoma is healthy, the whole site is flat (hooray!!), and my Cymed pouches last a week when I don't have chemo diarrhea.
e. If you need to change the pouch faster than 5 days, Hollister and Convatec products were very hard on my skin, pulling off layers and eventually creating wounds that needed special attention from my wound care nurses. They had large 4 x 4 bandages which acted like skin and promoted healing within a week. I can't remember what they were called but they were the best invention since air conditioning.
f. Are you close to a wound care nurse or ostomy nurse? Don't be afraid to seek professional medical help, even if you have to travel a few miles. You were not born knowing how to deal with all of this. And while you might find an ostomy nurse who hasn't seen your particular situation, I bet he/she is creative and inventive, and does everything possible and then some to correct your problem.
I didn't check to see if you were in the US or Great Britain or elsewhere. If you are in the states, I feel we have so many problems with these issues because we don't have local ostomy clinics like they do in GB. We should have a place to go regularly where the medical personnel understand what we are going through. They would know their way around a wound, hernia, non-sticking pouch, skin degradation, and our frustration or flat out depression,
We have one professionally trained ostomy nurse who is technically only supposed to see admitted patients in the hospital. She manages to see discharged patients having difficulties by sitting them in a wheelchair in the restroom at the hospital. She also trains the floor nurses in how to care for us after surgery.
Most Registered Nurses and doctors here in the states are not trained extensively, nor do they have much experience with patient aftercare, whether physical or emotional. Those of us who do not live in a major metropolitan area feel like we are in an ostomy desert with no support or help.
You are not alone. It is normal to feel the frustrations with pouches or rental cars, but there is hope. You can come out of this on the other side of hopelessness. It took me 6 long months. I had to deal daily with EMP and Blue Cross Blue Shield and that seemed to take everything out of me. But perhaps that's how I was able to deal with all of the other changes going on in my life after surgery.
