• When first placing it, how should the barrier ring fit next to the stoma? Tightly? Any skin showing? I tend to make it snug. Because barrier rings aren't stiff and sharp like a wafer, there's no danger having it close to your stoma and it should work better if there are no gaps. 
• Do you stick it to your skin or the appliance first? This is personal preference. 
• Compared to the barrier ring, how big should the hole in my appliance be? A few mm gap between your stoma and the edge of the wafer. Wafers will swell a little and fill the space, but making the hole too large or small can have problems. You'll learn from experience what size hole is best for you, but you'll need to adapt for the first little while as your stoma may continue to change size over time. 
• Do the barrier rings come in different sizes? size and thickness!
• My stoma’s hole is on the side of the stoma, does that make any difference when using barrier rings? This could cause it to erode more quickly and cause leaks. Find a barrier ring that doesn't melt as easily, like the Coloplast protective ring. 
• Has anyone heard the acid-producing foods (coffee, tomatoes) affect the efficacy in our supplies’ stickiness? I've heard people say this, but I haven't experienced any ill-effects when consuming these foods. Some may cause changes to your output, which could indirectly cause issues. 

You almost certainly need some kind of a convex to push the stoma above surrounding skin level a barrier ring stuck either to the bag or directly around stoma might help to seal any unevenness of the skin. John is absolutely right skin must be dry otherwise it will seep under, stoma powder or calamine lotion or barrier spray can be used.

What type of stoma do you have it will help us to offer some suggestions.

Can you not get a zoom or skype call with a ostomy nurse I'm amazed you've not had the support???

As John says it takes time and some experimenting to find a workable solution

It’s been three months since surgery and I’ve had a very difficult time. Due to leaks, I am changing the pouch at least 1x day. I am almost afraid to eat (not good when you’ve lost 30 lbs. due to cancer) or do mild physical activity. I know it will get better but…thank goodness I have the most patient partner in the world.

I am still trying out new products. I have a small stoma that slightly protrudes. It can go almost below skin’s surface. I am exploring different convex appliances now, but not getting more than 12-24 hours’ success before leakage.

A while I had some GREAT luck with the barrier ring and then my stoma got smaller. The seal would then allow too much leakage and it would actually pop up right through the appliance hole.

Now for my questions:

• When first placing it, how should the barrier ring fit next to the stoma? Tightly? Any skin showing?
• Do you stick it to your skin or the appliance first?
• Compared to the barrier ring, how big should the hole in my appliance be?
• Do the barrier rings come in different sizes?
• My stoma’s hole is on the side of the stoma, does that make any difference when using barrier rings?
• Has anyone heard the acid-producing foods (coffee, tomatoes) affect the efficacy in our supplies’ stickiness?

There are no certified Ostomy nurses in my area. I so appreciate finding this community, and I found the videos to be excellent.

I look forward to your support and hope that I can also be helpful someday.

Definitely have to be dry skin. I have to dry the stoma itself then immediately apply the ring round the bottom half. ( standing in shower ) And be quick to get the rest on. Having just taken advantage of the changing routine to take a long hot shower, I also have to take some time for the skin to really be dry. Lots of wiping with paper towel.

Still wearing the one I applied 6 days ago. Changing it tomorrow morning. My record so far. I think I would be very happy to get 5 days average wear.

The rings are supposed to swell up and snug up to the stoma. Sometimes I get quite a turtle neck round it. I do notice that the ring does not stick to the skin as well as the base plate does. I also notice that I will get some burning sensation soon after a change. I think there is quite a lag time for the ring to expand to it's useful size and purpose. I left one in a glass of water to see what it did. Left the protective layers on. It very slowly.... expanded out from between them. May be a lot faster with actual stoma fluids. But that convinced me to wait longer when I suspected a bad appliance change.

It may be that the fluid does sometimes leak under the ring at first. Get some burning sensation. But if I give it a second chance before replacing, it seems it will often seal up. I also get a lot of annoying sensations all under the base plate anyways soon after a change. If I give it some more time, the ring gets more sealed up around the stoma, and the sting stops. The ring is not sealed well to the skin, but is sealed up round the stoma?

It's a real judgment call. Don't want burnt skin. Don't want to waste time and resources on appliance change. Getting the feel of it now.

Sometimes we do things that just defy the odds and are successful. I totally get that! Good for you!

Stella