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Cyrisse
(@cyrisse)
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September 17, 2019 6:36 pm  

I have had an ostomy  for  6 months . It's really not that bad once you get your game together. I am a Hollister girl. Issue is my stoma changes size every now and then I have been  1 3/8  most times and do balloon out to almost 1 ½ like now. I have called Hollister help services a few times for various issues and it seems like all of them have a different remedy. For instance, I was told today that if I see a little bit of skin around the wafer , you should not see ANY any skin skin for a good fit, told to use barrier strip or barrier rings. So I am in between 2 sizes. I do have cut to fit wfers. Wonder how should I handle this problem. Any ideas would be appreciated.


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Awc19
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September 17, 2019 8:42 pm  

Hi Cyrisse,

I use Hollister 2 piece pouches. I haven't had my ileostomy very long but once my stoma  healed it hasn't changed size. I am not sure what you mean about seeing skin around the wafer. I use the wax barrier ring around my stoma and make sure it is snug up to my stoma. The wax ring can be stretched and molded to fit around the stoma. Then I put on the wafer which I have cut to make sure it isn't touching my stoma but is about 1/8" away all the around. The wax will swell up a little and keep output from getting under the wafer. Do you use the paper sizing chart to determine what size to cut your wafer?

Hopefully, some other more experienced people will chime in with their thoughts and suggestions.

Good luck,

Alice 

Alice


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Dona
 Dona
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September 17, 2019 9:48 pm  

Hello Cyrisse, and welcome.

I too use Hollister two piece. My stoma changed size for about six months after I got it.

I am lucky enough to have a stoma almost the same size as one of the pre cut wafers. Its a tiny bit larger ( which is good). To that I add a barrier ring. Eakins cohesive. Remove the plastic backing that is over the center of the wafer. Then I  warm  up both the wafer and the barrier ring ( hairdryer on low) and then stick it to the wafer. Then I press down to make sure it sticks . Then I smooth it down so the edges are not so abrupt...at the outer edge.

Then I flip it over and open up the barrier until it is very close to the size of the whole in the wafer ...whatever you need to fill that gap. SHouldn't be much. Then I warm and dry my skin ( careful with that hairdryer around your poor defenseless stoma). Then I press it down over my stoma and down onto the skin. Keep up the light pressure for about a minute. Take off the tapes edges ( if you haven't yet) and press those down too.  Now relax a bit !! I do this lying down ...every one has their own quirks. This seems to last me 5 to 7 days.

If you have a good fit, and nice dry warm skin .. this should seal everything up and protect your skin. Since the barrier material kind of wraps around the wafer, this also cushions your stoma from the edge of the wafer.

 

I also use a bit of the stoma powder just at the base of my stoma.  This seems to dry up any moisture. Seems like its some kind of glue? in powder form . ( probably someone here knows).

 

Good luck with all this. Its really much simpler than this long  bit of text! I think I posted a picture of this somewhere on VO.

Onset of severe Ulcerative Colitus Oct.2012. Subtotal colectomy with illiostomy July 2015; Peristomal hernia repair ( Sugarbaker, mesh, laparoscopic) May 2017.


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Tony
 Tony
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September 18, 2019 8:22 am  

Hi Cyrisse,

 

I don't have much to offer here, but I do want to add one thing. Your stoma size will vary for a while. Sometimes it can take up to a year to get it stable. You might find that certain foods might make it bigger. I found that was the case when I had more than one banana in a day, so I had to start watching that, as an example.

Tony
Crohn's diagnosed in 1995.
Spontaneous colon perforation and emergency end ileostomy surgery in 2018.
No colon - still rollin'!
No eyesight - life still bright!
Stomaversary - December 4th


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LK
 LK
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September 18, 2019 10:32 am  

Welcome Cyrisse...Have you named your stoma?  Meet mine, she  is Rose. Lol.  I am 10 years in and also Hollister, one piece user.  You are right, it is a doable situation in life and acceptance and a support line is a huge part of it.   A few things, measure your stoma when you change your pouch just to be sure and to help avoid skin issues from a leak. Not enough paper ones, call the company and ask for me they will send you more.  Also because you have pre-cut, use your plastic piece to check for stoma size changes then apply the wafer.  Too tight a fit can hurt your stoma and too large a hole can cause leaks and skin issues too. It is okay to have a bit of skin showing but like you I prefer a good to the edge fit.  The skin will toughen up to the acid produced in your output and eventually may change tone a wee bit around aprox. 1/4 " out from the  edge.   It is best to avoid  leaks that all together if you can but not a likely scenario.  Eventually you may have a stoma size change in the middle of a wear time and then the output will get to your skin then too and likely irritate it.  Heat and cold temp. can be an issue for change and I find even stoma size sometimes.  I have learned to always carry the graph with my away from home supplies. I never use the pre-cut system because of the changes that can occur and that can be costly.  You may have noticed that near the end of the wear time you do have some output residue under the wafer no matter the fit.  Stoma powder is used to keep the skin dry and not a glue of some kind, sorry Dona, but it is for absorbing moisture when you have a skin sore that needs healing or redness you want to avoid becoming worse off.  To keep the powder in as minimal an area as possible, I put it on my finger and then pace it on the skin or the sore.  Blow off the excess.  You can do a crusting technique if you like and Eric has provided a video on that too.  He is amazing.  About three years ago after a leak I remeasured my stoma and mine had gone to a down facing capital D shape.  It is still this way today.  A weight gain or weight loss can change that too.  There are ways to get the exact shape you need to cut, but it is okay to not have that exact fit all the time.  Using the rings and flattening them to your desired size and width are good measures to use, but I have not used them since I joined the site here. The strips are good if you have a small valley that needs filling.  I learned so much here,  it made my life with Rose so much easier all around and I found Osto buddies that knew how I felt and what I feel when no one else does. If your stoma happens to bulge with gas and flow like mine does once in a while, too snug a fit can hurt her a bit.  I find this happens only the first day after a new change because the wafer edge has not softened and warmed up yet.  It is your choice to use the rings or strips. I do not miss the sticky stuff.  I hope this answers your question.  Do not be a stranger here and ask anything you like. Feel free to us about your story to the ostomy also.  All the best!

Linda

Linda


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LK
 LK
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September 18, 2019 10:35 am  

FYI...As grateful as I am for them, keep in mind, tho Hollister is wonderful I have not met one yet that actually lives with a stoma and the pouching system.  They read their answers off a computer site.  Not by personal experience.  

Linda


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john68
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September 18, 2019 11:04 am  

Linda I totally agree, I Find my company brilliant to deal with, Yep here comes the but!! That’s where a stoma nurse is so important and sharing with others on the forum. It’s one thing talking the talk it’s another walking the walk

ileostomy 31st August 1994 for Crohns


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Cyrisse
(@cyrisse)
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September 18, 2019 2:37 pm  

@dlkfiretruck

Thx for your reply. My appliance is named Bella. I am 64, a retired RN. Long history of diverticulitis with no acute distress stress until recently  Had colostomy done in March this year bec of a blockage seen via colonoscopy. Was going to Egypt in April, told the Dr before the test and he said since I had been ill it would not be safe to travel abroad. Good thing I did not, I would’ve been in danger. Surgery went well, planning to have a reversal in August 2020 when my Medicare kicks in which I have to check. No health insurance right now. So that’s the plan. Usually I never get sick but when I do it’s very expensive and usually have some problem with abdominal stuff. So far so good. Again TY esp for reading my long reply 😎🌴


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VeganOstomy
(@veganostomy)
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September 19, 2019 1:49 pm  

Lots of great feedback here!

@cyrisse

While a stoma may settle at a consistent size, you might find that it may still grow and shrink a little (mine still does after six years!). That's why I tend to always measure and use a cut-to-fit. 

Personally, I would rather there be a little gap between my stoma and the hole since the hydrocolloid will swell when it comes in contact with moisture, which will fill in any small gaps. However, if you make the hole too small, then you'll have all kinds of problems from bleeding, blockages, and pain - not fun! I always err on making that hole just a little wider than my stoma. 

Good luck!

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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sjlovestosing
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September 19, 2019 3:19 pm  

Great advice, Eric! I prefer to have a little space in order to accommodate any expansion.

Stella


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madrikh52
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September 22, 2019 6:52 pm  

I use the Eakin seal rings under my wafers because they seem to sort of cushion the perimeter of my stoma. Paste or strips will serve the same purpose. In my experience, if you see skin, the chances of a leak working its way under your wafer is increased

Marci


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LK
 LK
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September 23, 2019 1:15 am  

@cyrisse

Honestly, I have you out logged in long replies. Lol! Just ask the gang. LOL. I can't imagine travelling and having something go wrong like that.  I can't  imagine what might have been for you had you been overseas when this surgery happened. I also can't imagine not having the availability of medical insurance, that must be horribly frightening. I nursed in geriatrics back in the late 70s. I loved working with the elderly but was on a long stint of night shifts and it practically killed me. The exhaustion was debilitating. I hope you can travel someday again soon. Talking about the size of a hole to cut I want to add that since Eric had pointed out how to get a good fit for a hole and a cut on the other side of the line that we make I have had very very few issues with leaks and skin problems. There are lots of good people and advice here, it's finding the pieces of the puzzle that fit for your life. All the best Cyrisse. 

Linda


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Fred
 Fred
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September 23, 2019 5:47 am  

Hi Cyrisse,

I have had my ostomy for 4 years and use Hollister 2 piece pouches.  Initilly, I tried using their barrier rings but was not satisiefd with the wear time. They seemed to melt away from my stoma leaving bear unprotected skin around my stoma.  I switched to Coloplast barrier rings and found they work much better. I shape the ring to fit my stoma snugly then put on the wafer.

Hope this helps. Good luck.


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LK
 LK
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September 23, 2019 9:17 am  

Cyrisse...something about your original post here has been troubling me. I have re-read this  forum three times and I have a feeling your question has not really been answered. So I'm going to ask if you are wondering how to cut the hole when you are in between two sizes of the Rings that are provided on the graph we use to measure our stoma? Because mine became a down facing capital D, I had great difficulty getting the correct size and my skin paid for it. I fully understand your concern there and requiring a good fit for you. Before I get into how to measure something that is changing shape and size I will wait for your reply.

Linda

 

Linda


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Cyrisse
(@cyrisse)
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September 30, 2019 7:31 pm  

I would like to thank all of who responded to my question.


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Cyrisse
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September 30, 2019 7:33 pm  

I would like to thank all of who responded to my question.


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Awc19
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October 1, 2019 8:56 am  

@fred

I noticed you mentioned you use Hollister 2 piece appliance in combination with a Coloplast protective seal because the Hollister barrier rings tended to melt away. I have recently started having this problem too. I would like to order the Coloplast to try. I have 2 samples of the Coloplast rings of 2 different thicknesses. I am not sure which to try first? I do have way more watery output than thick and always have so I think it is just easier to get under the wax. I change my appliances about every 4 days. I am going to change more frequently until I can get this issue under control but for convenience would rather be able to go at least 4 days between changes.

Thanks, 

Alice

Alice


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Fred
 Fred
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October 1, 2019 12:17 pm  

Hi Alice,

I find that the thick rings have a better seal and longer ware time.

 


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