Hi guys - I have tried a number of manufacturers flat bags in the last few days. I have been cleaning the skin well and drying with a cold hair dryer, I am then applying a small amount of powder to the sore areas and wiping off the excess, I am then applying a small amount of barrier cream, then fitting the aloe barrier ring to the bag and sizing it to the opening (I have measured the stoma and it is 29mm and bag is cut to either 29mm or 30mm), I am applying the bag with the barrier ring over the stoma and securing to the skin. I have had leaks constantly and woke this morning to a beautiful (sore) readymade pancake leak.

2 questions please.

could you comment on my routine and let me know if you see any potential leak causes please

having moved from a convex bag to the flat bag, I miss the security of the support belt that connects to the convex bag, I notice that two piece bags have the tags for attaching a support belt, would two piece bags be a option.

as it stand I am getting hours out of a bag before I need to change.

all suggestions and help appreciated.

cheers

dave

Hi Dave, tell me what are you using to clean the skin before applying the new bag. Plus try that hair dryer on a heat rather than cold. Also try just the wafer and bag. A lot of wafers have all you need to keep skin in good condition. When the skin is leak free you will soon see it heal. Yes the 2 piece can be worn with a belt. I also when have the appliance on will put on my tee shirt and warm and rub around the wafer for a bit. I know you may say why all these products rings, paste etc and he’s saying not to use. You may find u don’t need them. They are there for reasons if folk do. 

@cardc 

Hello Dave and welcome to the forum.

I am sorry to hear of your issues. I have to agree with John, though - the less product you can get away with the better. Right now, the most important issue is to heal that skin around the stoma. I know how painful it can be. You say that you need a convex system. Is the area around the stoma irregular in such a way that you would need one? Have you looked at the body check on the Coloplast website? Have you asked your surgeon or stoma nurse for advice?  

I myself use the Sensura Mio light convex and use a little paste in my dips around the stoma. That has worked for me and, since I started doing that, have had no issues with leaks and sores. 

I hope this all helps.

God bless.

@john68 John - thanks for the suggestions. I am using a adhesive removal spray to tag the bag off. From there I use water and a cotton type wipe to clean around the skin and the stoma. 

When dry I am applying some convatec powder, then cavillion barrier and then the bag with the ring. I tried the bag without the ring and leak happened over a few hours. 

I now have a sample of a concave bag and a two piece system from the stoma nurse today and I will try them.

I will also turn the heat up on the hairdryer..

cheers

dave

@sjlovestosing appreciate the comments and help. I have two new bags to try from the stoma nurse today and will see if they hopefully work.

they had given me the convex bag originally and now suggest a concave bag may be more suited.

thanks for the help.

cheers

dave

Hi Dave,

Leaks can sometimes have multiple causes, and trying to pinpoint those causes can take some trial and error.

If you haven't already seen it, please have a look at this article for a few other things to try and/or keep an eye out for.

I do believe that less is more with ostomy care, but that doesn't mean everyone can get away with just a wafer and a bag. 

I haven't used the concave appliances, but I'd be interested in hearing about your experience if you do try them. 

Hi there. Just chiming in here, better late than never... Been lurking but never posted. 

Dave, I have a similar routine to you BUT, once I dropped out the Cavillon wipes, everything stuck sooooo much better. Just an idea!

Good luck

Are you sure your stoma is 29 mm? Mine is less than 20 mm at the base. I started out using a barrier ring. Putting it as tight as possible round the base of my stoma. I would start to feel the burn of a bad seal at random times. Within 24 hours or longer. Got some burned skin issues.

Juice was seeping under the Bravia ring quite quickly. The ring itself was in pretty good shape. Swelling up properly. But it seemed to adhere a lot better to the wafer than my skin.

I had some burnt weeping skin. The Bravia skin barrier wipes seemed to help that heal up well, while I figured out things.

Here is my scheme, that lasts at least a week consistently. Get an accurate measure of the very base of your stoma. The diameter just where it joins the skin. Not just where the paper circle can go over it. I notice in the shower on change day that the squirt can change diameter and length quite dramatically. Guess it enjoys a hot shower too.

For me it seems best to make the hole on the tight side. I really squish that squirt through the hole. But. I make sure everything is absolutely dry. If you use a skin barrier wipe, let it completely dry. I have paper towel wrapped round it till the moment I squish it through the hole. The stoma is constantly producing fluid. When you slide the wafer over it, that will spread the fluid out under the wafer edge there. It seems the fluid has a bit of an oily feel in my case. Probably bad for a seal.

I have a tube that fits close round my stoma. I press it hard while tensing my stomach muscles. I often hear a bit of air squirt out. If it had not been squeezed out, that would have likely been a bad application. I no longer use a barrier ring.

My gear is the Sensura Mio Click 2 piece. I imagine that the hard plastic connection ring might help lessen bending loosen the seal round the squirt. Maybe. No barrier ring or skin barrier products now.

When I was cutting the hole a bit larger, I sometimes noticed a bit of burning near changing day. So I would remove the bag. Rinse with the shower head. Apply some stoma powder to any obvious gaps round the squirt. Seemed to work quite well. Get me through to the regular change day.

Took me a few months to get the scheme down for me. Now I easily get a once week change. Sunday morning long hot shower and change.

@veganostomy I tried the concave bag, it fit like a glove and was comfortable to put on. The issue I had was as it’s concave and one piece, it was hard to keep air in the bag and/or some toilet roll to prevent pancaking. I found the multilayers in the bag made it hard to push output down. In saying that when I removed the bag, there was little or no seepage under the barrier ring. I have continued to use the barrier rings and now am using the hollister 2 piece samples and they are allowing me to push change out to 24 to 36 hours which is great. I am awaiting the two piece concave and I am hoping that will provide the best of both worlds.

@sullyfish thanks for that. I have dropped the barrier cream and have found a huge improvement in adhesion!!

@cardc hoorayyyyyyyyy!!!

All the best for some peace from it!!

@kedikat appreciate the run through your routine. My stoma is 29mm, and yes it does change slightly based on time of day and cold/heat. I’m now cutting the bag to 31 ish as at the bottom of the stoma is a little bump (I know there is a correct term, but I cannot remember it) and if I cover this or have the bag too tight to it, it bleeds and gets sore. I am putting a brava 32mm barrier ring into the bag and pushing it in slightly to over the bag hole.  I am waiting to try the Sensura Mio Click 2 concave and will see how that works.

I was in with the stoma nurse last week and they reckon the concave may work as I have a bulge around the stoma site.

I have not been brave enough yet to turn the shower on stoma and when I have left out the barrier rings, I found leaks happening very quickly, but that may change with the right appliance.

Thanks for the help.

Hey - also just a comment on this site. Huge compliments to Eric for the site and all the contributors. It’s huge trial and error to get the right routine and appliance combinations. But the tips and tricks and help from this forum and the site in general are making a challenging, scary journey easier and I just wanted to say thanks!!! 

Nothing else like it online or really any where! We are like logs?? One doesn’t really make much of a fire. Put a whole heap on and you really feel the benefit. Sorry everyone for calling you a log!! But my wife does call me a real plank😂😂

@cardc Awesome to hear! I'm glad it's working better for you!

Regarding, having issues keeping air in the bag, the best solution to this is to cover the outside filter opening with tape or a filter sticker (should come with the bags). This will prevent air from escaping, but you can remove the sticker when you need air to escape (provided that the filter is still functioning as expected). 

I've been using filterless bags for some time because of the issues that filters create. 

Hi guys - hope you are keeping well. Still consider myself relatively new, so thought I would continue this thread and ask a question(s)

1. I have started blending and am considering looking at juicing as a way to get fibre (fruit and Veg) into my diet. I cannot eat them as I find it creates blockages. Appreciating the Vegan part of this site, any tips on smoothie or juice recipes that you have found work well.

2. 7 months post Ileostomy being formed and 4 months post procto colectomy completion, I am having severe cramps in muscles and joints, I have been scanned within a inch of my life and nothing is showing. I have read that post procto colectomy that this pain can be experienced by patients and can hopefully pass in time. Has anyone else experienced this. A good example is, if I sit for more then 10 minutes it is hard to stand up and takes a few minutes for muscles and joints to relax and let me walk normally.

3. Output has moved from porridge to predominantly liquid. Can this be related to still on very low residue.

thanks in advance

dave

Posted by: @cardc

1. I have started blending and am considering looking at juicing as a way to get fibre (fruit and Veg) into my diet. I cannot eat them as I find it creates blockages. Appreciating the Vegan part of this site, any tips on smoothie or juice recipes that you have found work well.

I like to keep smoothies really simple, although, you can find recipes that are quite exotic or complex. 

Nearly all my smoothies start with bananas and non-dairy milk as a base, then I'll add either fresh or frozen fruit, but not more than one or two (I like it really simple 😂), so maybe mango or pineapple. 

Some smoothies that include greens can cause more output (for me, it's raw spinach), but everyone is different. 

2. 7 months post Ileostomy being formed and 4 months post procto colectomy completion, I am having severe cramps in muscles and joints, I have been scanned within a inch of my life and nothing is showing. I have read that post procto colectomy that this pain can be experienced by patients and can hopefully pass in time. Has anyone else experienced this. A good example is, if I sit for more then 10 minutes it is hard to stand up and takes a few minutes for muscles and joints to relax and let me walk normally.

I did have pains following surgery for some time, similar to what you describe (although, joint pains have always been part of my illness).

I would continue to explore causes with your doctor. I'm not sure why you'd have muscle pains, or if they are related to the surgery, assuming there are no other underlying conditions that could be causing this. 

3. Output has moved from porridge to predominantly liquid. Can this be related to still on very low residue.

I would bet on yes, however, it's common for ileostomy output to be loose or liquid. "Normal" for one person could look vastly different from "normal" for someone else. 

My output can be very thick... Like modeling clay, and at other times it's liquid. LOL 

Increasing fiber, especially the soluable type, can help to thicken it up. Starchy foods like pasta, rice, potatoes, etc. nearly always work for me. Adding ground flax seeds to your smoothies can be another option 😉

@veganostomy thanks for the response. I will give the smoothies a go and see how they work.

appreciate the comments on pain and output also. It’s good to hear that what I’m experiencing is not unique, that’s not saying I’m glad you have similar experiences, but sometimes the medical feedback can be very black and white and if they don’t find a specific root cause, it can be like it does not exist. So it’s good to hear I’m not special!!

cheers dave

Posted by: @cardc

and if they don’t find a specific root cause, it can be like it does not exist.

Knowing something is "off" but not having a diagnosis can be very frustrating. It could end up that these pains simply go away without you ever knowing the real source, but please keep your doctor in the loop if it does continue for a while longer or gets worse, 

Id like to add that I’ve been binging on fruit smoothies no milk just blend an assortment of fruits such as berries bananas and oranges (including a lime or 2 or grapefruit) along with kiwis. I add ginger in it and mangoes as well as pineapple and ginger it’s amazing how you feel after such regiment when you start drinking this regularly. Mind you it gets pricey having so many fruits in it but certainly notic the difference in my energy. I also eat less meat I notice during my regiment as well.

i notice that any discomfort with my stoma usually settles down for a while and I seem to absorb liquids better during that time. Get ready to have thicker output and some pancaking occurring as well.