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Measuring an Oval Stoma  

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Tod888
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September 26, 2018 9:32 pm  

Hi All,

5 months into this and hoping for some guidance on how to accurately measure an oval stoma. 

I currently measure the height 25mm and width, 35mm...and then try to cut something approximating the shape by guesswork. 

Any hints or tips please? 

Thanks in advance...

 

Crohn's diagnosis 2015, severe flare April 2018, Total colectomy, Stomi born April 20, 2018


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Sasquatch
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September 27, 2018 8:19 am  

Take some time when you change your bag next time and use some thin cardboard or something similar to do your guess work.  When you find the shape and size that works, use it as a template to draw it onto your wafer before you cut it out.  If your wafer has a durable backing, keep that for you next template.  If your stoma is anything like mine, you'll have to do some adjusting once in a while.

UC since 2002, subtotal colectomy Dec. 2016, proctolectomy Nov. 2018.


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VeganOstomy
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September 27, 2018 10:29 am  

I echo what Sasquatch wrote. Keeping the plastic liner from the back of your wafer is a great way to simplify things - assuming your stoma isn't changing size too often (like mine does). 

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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Kathleen
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September 27, 2018 1:36 pm  

I use the backing of the wafer as a template, but also, because part of the bowel is protruding and making it very awkward to get the opening over and onto the skin accurately this what I do. I first fit  a barrier ring snuggly around the stoma and cut the wafer quite a bit larger to get it over everything. This means that the wafer sits on the barrier ring with a larger than text book space from the edge of the stoma opening. This has worked well for us. We can  usually go 3 days between changes. A nurse I contacted in the early days told me it was fine if there was a small gap as long as you used a barrier ring first. 

Katy


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Sasquatch
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September 27, 2018 2:29 pm  

I don't use a barrier ring, but I don't mind a little space around my stoma.  My wafer will swell slightly as it absorbs moisture, so I don't mind a 1/16" gap.  In my opinion a little gap like this helps you have some breathing room when you apply it.

UC since 2002, subtotal colectomy Dec. 2016, proctolectomy Nov. 2018.


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Tod888
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September 27, 2018 11:05 pm  

Thank you all for your feedback, I will try the thin cardboard on my next change and see how I go. I appreciate your suggestions and support. 

Crohn's diagnosis 2015, severe flare April 2018, Total colectomy, Stomi born April 20, 2018


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LK
 LK
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September 28, 2018 7:22 pm  

Hey Tod...there are several ways to get the shape you need. Mine was  hard to get the size I needed. I have two things I do now as my stoma has its own personality, and changes shape often. Annoying as it was the same for 11 years!  I took the one inch whole I had made normally, placed the wafer plastic covering  onto my tummy over my  stoma, then I used strips of scotch tape to fill in the space that was there. I have eczema so I prefer to cut my wafer  to the size I need with very little skin showing if any.  After I taped up the space I was able to trace it out on another plastic from the wafer,measured it again to make sure it was the size I needed and it was done.  Good luck!

Linda


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Kathleen
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September 29, 2018 4:52 pm  

Great tip! Also noticed in a Hollister demo video using the last wafer backing as a template that the person cuts on the inside of their drawn line. To be accurate you need to cut on the outside of your line. Otherwise you risk the hole getting slightly smaller each time.

Katy


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danbh
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September 30, 2018 1:31 pm  

I have given up on the Stoma measuring, I have never had any trouble with my skin around the Stoma, but I have a feeling that it will catch up to me one day and give me skin trouble.

I have a Colostomy, and my Stoma is a large piece of meat, coming out sideways, after a repair of prolapse last December, Doctors orders are no lifting of anything over 20 LB, but I don't have to lift anything for that Stoma to come out once I get up from bed, get big, fat, and ugly, and grows towards the left side of the bag. I tried laying down and letting that piece of meat running back to it's hole, and doing the change laying down, but as Eric said, your skin is relaxed while laying down, if you attach the wafer this way, when you stand up, the skin tightens, and the wafer pulls off the skin, so I have to do it standing up, with that large piece of meat hanging, not allowing me to see what am I doing underneath it. On top of all due to my diabetes, my eye sight is all screwed up.

If anyone has this same problem, and solved it - please let me

Thanks

 


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VeganOstomy
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October 2, 2018 9:03 am  

Hey danbh, 

That sounds challenging. Moldable wafers were mentioned before and I'm curious if you've tried them.

 

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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danbh
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October 6, 2018 11:06 am  

Hi Eric,

We have talked about the moldable  wafer, and I do use them. Originally I did mold those around my stoma, but after 24 hours, the mold built a wall around my stoma, and blocked output from going down the bag. I went to a stoma nurse, and showed her this wall, right away she told me that my stoma is a large one and I still need to cut it so there is not enough material there to build this construction around the stoma. After that I had a correcting surgery for a prolapse stoma, and thought I can go back to normal. My stoma did not think so, I am getting now another prolapse, and just by getting out of bed, the stoma wakes up with me, and comes out to see the world. It now comes out side ways, and it depends on the way I stand, sit, or lay down as to what size and shape the stoma would take.

 


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VeganOstomy
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October 6, 2018 1:31 pm  
Posted by: danbh

We have talked about the moldable  wafer, and I do use them. Originally I did mold those around my stoma, but after 24 hours, the mold built a wall around my stoma, and blocked output from going down the bag.

Which brand did you use? I find that each brand's moldable wafers (and there aren't many who make them) behave differently and you might have better luck trying another.

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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danbh
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October 11, 2018 5:47 pm  

I am using the Hollister new image 14104. My stoma nurse tried one other she had on hand, and she did not cut that to prove to me the need to trim them. She was right, it also built that same wall around my stoma. I did not write down what brand it was (sorry), and it did not stay on me for more then 24 hours. I have watched all your videos, and you show your stoma, which may change size a bit as you say, but nothing like mine does. The picture I enclosed is my stoma before my prolapse surgery, it is now just about half this size, and I may go for a second prolapse surgery. I hope this picture would not disturb users, if it does please delete it.

1539294477-20171203160030.jpg

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Bubbles
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October 11, 2018 6:55 pm  

Dan wow that is crazy. So sorry. 😢

 Bubbles 


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VeganOstomy
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October 11, 2018 8:17 pm  

Danbh, thank you for sharing that. Prolapsed stomas no joke and I'm glad that the surgery at least made it more manageable. 

What I believe happens with prolapsed stomas and stomas that simply point downward, is that they are constantly wet on the wafer, which degrades it much faster than normal. 

One thing you probably haven't tried (and I honestly don't even know if they are ok to use with prolapsed stomas) are stoma collars:  https://www.veganostomy.ca/guide-to-ostomy-stoma-collars/

The idea is that they can help to keep your stoma off of the edge of your wafer, which should prevent the quick breakdown you're experiencing (or at last, that's what I hope will happen). 

Unfortunately, they may not be available in your size of stoma - the largest that Salts has is for 39-41mm (diameter) stomas.

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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Kathleen
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October 12, 2018 2:20 am  

Thank you for the photo. It looks similar to my husband's peristomal hernia but what he has is a large part of the ileum hanging over his "flush to the skin stoma". It is causing a lot of problems which I am sure you can imagine. I would very much like to know what kind of surgery you have had on your prolapsed stoma and have you found it has made life any easier? And are there any plans for further repairs?

I hope you are doing well and I really appreciate you sharing. 

I have attached a very poor photo of our Stoma to show what I mean. It changes in size and can be quite swollen at times.

Katy


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Kathleen
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October 12, 2018 2:21 am  

Oops sorry forgot the photo.

1539325309-Igor.jpg

Katy


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VeganOstomy
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October 12, 2018 10:42 am  

Hi Kathleen,

I can definitely see how that can be problematic. I hope your husband has had the support of a good stoma nurse to help with it.

 

 

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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Bubbles
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Posts: 244
October 12, 2018 10:58 am  
Posted by: Linda Knelsen

Hey Tod...there are several ways to get the shape you need. Mine was  hard to get the size I needed. I have two things I do now as my stoma has its own personality, and changes shape often. Annoying as it was the same for 11 years!  I took the one inch whole I had made normally, placed the wafer plastic covering  onto my tummy over my  stoma, then I used strips of scotch tape to fill in the space that was there. I have eczema so I prefer to cut my wafer  to the size I need with very little skin showing if any.  After I taped up the space I was able to trace it out on another plastic from the wafer,measured it again to make sure it was the size I needed and it was done.  Good luck!

Linda filling in with tape to make a custom fit is genius. Bravo 👍🏼👍🏼👍🏼👍🏼👍🏼👍🏼👍🏼


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Kathleen
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October 12, 2018 3:56 pm  

Unfortunately, after waiting weeks to finally see our Stoma Nurse, she didn't even remove the bag. She had a cursory look and reassured us that we were doing everything correctly. She said it was just a slight prolapse, but I don't think that's correct. We see the surgeon at the end of the month but I am very worried for my darling husband who is going through so much with his cancer and there seems no one to even really just talk to. We are a bit remote here. Thank you for your site. Without your videos and info and the people who contribute I don't know what I would do. 

Katy


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