Thanks, Eric for the advice to both my questions.  My husband and I think that it's a good idea to put on the wafer first to make sure that it is fitting perfectly. After watching the video review of the Sensura Mio 2-piece and how it helped your stoma to heal after two weeks, the next time I change out my system I will  use just the barrier and pouch. I'll also try wetting the ring to see if it helps to attach the pouch to the barrier. (Last time I changed my system, I did apply the stoma powder and used a protective wipe as well.)

Stella

Hi Eric. Just wondering your thoughts on how well the pouch you reviewed holds up overnight? It looks really small, and for myself, as an ostomate, I fear this would blow out in the middle of the night fairly quickly.

Hi Songbringer,

The pouch is a "maxi" size, so it's a pretty standard size that I'm used to. Overnight, it seems fine - except - when it balloons, and this one balloons often for me. Ballooning is probably the #1 reason why I have night leaks and that hasn't happened in quite some time with the Hollister appliance I now wear.

You may want to at least give it a try, but if ballooning is a problem for you normally, then you'll want to keep an eye out on that and proactively try to mitigate it.

Hi Eric. I am used to wearing the Sensura Magnum 24/7. I've tried pouches in the past that are deemed "maxi", and I have just laughed at what some companies deem maxi. I have no interest in emptying a pouch literally every 5 minutes, and with the ones deemed maxi, that has always been the issue when I used them. Ballooning is a HUGE factor for me. I love the Magnum, as an ostomate, because of my absurdly high output, and it's capacity, and is excellent for nighttime, but with some garments, the spout is a LITTLE too visible...especially on a woman, and has caused me embarrassment in the past. How do you recommend mitigating ballooning? Hoping it doesn't require altering pouches.

Posted by: Songbringer

Hi Eric. I am used to wearing the Sensura Magnum 24/7. I've tried pouches in the past that are deemed "maxi", and I have just laughed at what some companies deem maxi.

Oh yeah, the Magnum is in a league all on its own! "Maxi" is generally used to describe what a typical ostomate might wear, but I agree that the name confuses things a lot.

There are quite a few suggestions on how to deal with Ballooning. I suggest starting here: https://www.veganostomy.ca/ostomy-pouch-ballooning/

I have had my illeostomy for 1 week now and here I am at 1:15 am panicking about which brand to go with.
My main concern is that I absolutely SUCK at putting these things on. I can’t seem to get the wafers to stick very well. Immediately after I apply them, they are already falling off. I have had better luck with 2-piece bags since I am able to see what I am doing, but it’s still not great. Do you apply yours while standing up? Any tips on getting them to stick better? Thank you for this review! I really like these bags and feel pretty good about them, but I really need more knowledge on how to apply them! :(

Hi Sarah,

There are a few reasons why a wafer isn't sticking (actually, more than a few). I have an article that might help to give you some ideas on  what to check:  https://www.veganostomy.ca/ostomy-appliance-wont-stick/  

My initial suggestions would be:

• Make sure to clean your skin using only plain water. Some soaps have moisturizers which will not allow the wafer to stick.
• Heat up your wafer. This can be done by rubbing it between your hands while the plastic liner is still on it; using a hair dryer at a low setting; placing it under you arm or close to your skin, etc. 
• When you apply it to your skin, take your hand and use gentle pressure on the entire wafer for at least a minute. 

Wafers use pressure and heat sensitive adhesives - if you don't apply pressure or heat (body heat is usually enough), then it doesn't have a chance to stick well. If that doesn't work, start exploring other reasons that might be impacting the adhesive.

I always apply my wafer while standing because if you are sitting or laying down and then go to stand up after applying your wafer, you may stretch the skin and cause contact dermatitis. This would be most apparent around the edges of the wafer and you may even notice bleeding there. 

Good luck!

Hi Sarah, Follow as Eric says and ye won’t go far wrong. Take your time prepare and leave and equipment handy and don’t panic. Before you know it changing will be as routine as brushing your teeth 👍

Hello and welcome, Sarah.

You WILL get the hang of this. It is scary at first as you know. Eric's advise is right on. Just keep those things in mind. Dry area, clean and warm. Warm the wafer, and use pressure.

Once you have a good fit and get more familiar with the whole process there will be , honestly, times you forget you are wearing it.

I do my changes laying down,  with pillows at my back. Gravity seems to help and I can relax as I do it.

You might try keeping a diary of your changes, noting anything , and everything, that might be useful in the learning process. It is really hard to remember sometimes. Since you have only been at this for a week, you should also expect some changes as you heal up. Sometimes the stoma changes sizes .. just keep checking. Also, If you have access to a stoma nurse, use him or her.

Best of health. Let us know how it goes.

Hi Sarah...welcome! Wow, you are fresh out of surgery!  Things will go much more smoothly in time. I had similar problems with sticking and I have sensitive skin. Eric is right, it is hard on the skin to apply a bag sitting down, been there, done that, learned.  So sit if you wish, until your ready to apply a new bag...then stand. Things I wish I had known ten years ago...Now, of course, we have Eric, and they have sprays. I now used the adhesive "spray" remover and a few wipes. I could tell the adhesive was all off my skin, when the wipes would slip over it a lot easier. I wipe down and rinse the skin with a clean wash cloth and only water, give it a bit of a spa time, gentle circles to massage the skin, pat or fan dry. I use a non- treated laundry soap (Tide Free). Next, I use the skin barrier "spray" and a wipe or two. Unfold them and get to the center, then fold or scrunch them a bit from there, as they seem wetter on the inside. I make sure that I take extra care to apply it around the edge of the skin by my stoma before a new bag goes on. I cover my stoma with a couple squares of 3 ply toilet paper to catch anything wanting to escape, and protect it from the sprays. I am sure they are safe on the stoma, but it is just something I prefer. I believe Eric uses gauze. Some drug stores will sell a larger unsterile (optional) pack in the first aid dept. It would be the better product vs. TP.  Spray onto a wipe to get the feel of the spray can. If you use the spray and happen to spray too much on your skin, you can use a wipe to mop up, and then fan the skin to dry, make sure you get all around the stoma and skin area. Always check that skin with a mirror.  You can touch your stoma, it is kind of hard, and you will not hurt it. Because of fatigue, I lay down after a bag change with a WARM hot water bottle, place it on a towel over my stoma and tummy area and then cover it, five mins. is good. Read for a while or rest. It always pays off for me to take this step. Also when you first apply the pouch, make sure that you fold it over away from you so you can see just where you are putting it on the skin under your stoma. Then make sure the top side of the stoma is dry, TP or the gauze, I use a Q-tip with the fuzz part spun between two fingers (ahead of time) to keep it closer to the Q-tip, then I dry the stoma and gently nudge the stoma into the hole I cut. Then as soon as it is on my tummy, I gently press around the edge of the skin several times to give it the pressure it seems to need in that area. Not hard, just gentle circles. Then I work my way out to the edges with the same pressure to the rest of it. I have just used the heat of my hand, and it does work, but it seems I need the bit of warmth and rest time before moving around with a new bag on. Recline/ to encourage anything on the way out down the bag. You can massage it gently a few times to encourage sticking. Another thing I learned much later was to use these Brava, Elastic Barrier Strips by Coloplast, they are C shaped, 2 per bag, 20 a box.  It is an ostomy tape used around the  part that sticks to your tummy and is soft, pliable and gives me a whole lot of extra security and has even saved my clothes from a leak, they have a wider one as well, which is what I use if bending a lot and gardening. Help to remove with adhesive remover. Remember that your body has a lot of accepting to do, so drink plenty of fluids in between and with your meals, and take a rest when you need one. Take advantage of the samples, Eric has a list of the companies here somewhere. Your likely a customer for life so they want your business. Best wishes Sarah. I hope all goes well for you.  When your up to it, try and take a walk every day. All the best and stay well.

Linda

I'm just 2 weeks post ileostomy surgery and have been using my hospital bags and samples up until now. However, I am at the point where I need to commit to a bag and order now. I've most recently used the Sensura Mio one piece, but want to switch to the 2 piece for several reasons. However, I am having a lot of pancaking with this bag, even with using a lubricant. It didn't seem to be as bad with the Hollister bags I used, but I really prefer the design of the Mio and would like to stick with this bag if possible. My question is, should I just deal with the annoyance of pancaking and keep pushing the stool down, or is there something else I can try? I was thinking of getting the Mio without the filter (which as far as I know is only available in transparent) and using a cover. Maybe that would help? Or do you think it would be better to try a different bag? Ugh...it's so hard to decide!

Also, I really appreciate your blog and have come to rely on it almost daily. It's been a HUGE life-saver! Thank you!!!

Hi Gail, 

Give a few of these suggestions a try: https://www.veganostomy.ca/pancaking-ostomy-tips/

You don't have to go with a filterless option - try putting a sticker over the filter and see if it helps first. 

Good luck!

Hello Gail and welcome!  I use the one piece Sensura Mio convex and prefer the filtered bag since it is more discreet.  I also use a filter cover. Just make sure you add a little air to your bag if necessary (unless you produce enough gas to keep it slightly inflated.)  This keeps the bag away from the stoma. Good luck!

Stella

Hi Gail,

I use the 2-piece Coloplast SenSura Mio Click #10502 barrier with the 650-mL #18620 pouch, and I have a similar issue. It helps if I use a sticker for the first day or so. After that, the filter usually gets too clogged to continue working, so gas does stay in the pouch, and the pancaking goes away. A very aggressive filter is a common cause of pancaking, but you needn't go filterless and sacrifice the peace of mind you get from your favorite pouching system. Let us know how you make out.

Welcome to the forums.

Hi Gail and welcome to the forum,

You could also just use a filterless bag ( whatever you are using that works for you, but get a model without an integral filter) .Then attach and Osto EZ-Vent. Do them in batches.

There is info about Osto EZ-Vents on Vegan Ostomy. While this does add some time ( installation) and costs ( you usually have to purchase them ...amazon carries them) they have made my ostomy MUCH easier to deal with.  Its a small plastic contraption that you attach to the bag . It has a thing that you can lift out ( like on a beach ball) to vent the gas. So helpful , especially at night.

I use the Hollister two piece system. I used to get the bags that came with the filters, but they really don't work very well, and actually leaked FROM the vents after four or five days .. NOT the desired outcome.

Anyway, welcome and keep asking questions.

I don't know if they help with pancaking ( your original question) but they make it easy to avoid ballooning. For me pancaking occurs if I eat to much 'grainy' stuff. Nuts, seeds, dry crackers. Especially late in the day where it will be a problem later at night when I am laying down.

Gail,

i have mostly been using the convex sensura mio one piece. I got some 2 piece samples. The ones that connect with the adhesive work similarly to the one piece for me, but the click ones, I have trouble with the output backing up behind the ring. It is a bummer because I see a lot of potential benefit from it. Good Luck to you. 

Gail, welcome to you too.  Try and pic up the amount of fluids you drink.  Drink before  during and after your meal as well. It can help combat some of the thickness you are experiencing.  I also found eating a salad in between bites of regular foods, helps a lot with thick output. With your last glass of fluid after your meal, remember to drink between meals too.  I try and swish up my food with the fluids by swaying it with my torso.  Weird, I know, but it has worked to mix it all up and I can not remember the last time I had that kind of thick output after I increased my water in take.  (All things considering ofcourse. ) Be careful not to hurt your new incisions, so go gently. I hope you find what works. Be well.

Linda

Hi Eric, I'm commenting here, even though I prefer 1-piece systems, because this is where you wrote the most about the Mio pre-filter and its connection with pancaking. I've had my ileostomy for 27 years. I used a Hollister system for most of that time, but stopped a few years ago after they made some changes, which apparently included a change in formulation of their Flextend barrier. I started using Sensura Mio in 2017, specifically model 10482, a 1-piece system which, like almost all Mio pouches, includes the big full-circle pre-filter. It seemed to work well at first. But in 2018, I had 4 major pouch leaks (or blowouts), including an embarrassing one at a social occasion. The last 3 of those leaks occurred within a 2-month span. On analyzing them, I decided they probably involved pancaking on occasions when my output got thick, and the huge Mio pre-filter may have acted as an obstacle that prevented the thick output from spreading away from the stoma area. So I decided to switch to non-filtered Mio pouches (specifically model 10492, which is identical to 10482 but without the filter). I've been using these non-filtered pouches for more than 7 months now and haven't had any more leaks. Maybe it's too soon to be absolutely certain, but it looks like I've solved the problem.

Eric, you wrote that you'll get leaks due to ballooning but not pancaking. I seem to be the reverse. I've had serious leaks associated with pancaking but never any leaks from ballooning. Obviously, I get ballooning occasionally since I'm using non-filtered pouches now, but it hasn't ever caused a leak. And interestingly, I think I got just as much ballooning when I was using filtered Mio pouches, suggesting that Coloplast's highly touted Mio filter didn't prevent ballooning in my case. (By the way, during all the years I used Hollister, I was using non-filtered pouches. During those years, I occasionally woke up with a scary high-pressure balloon on my belly, but it always stayed intact long enough to reach the bathroom and empty -- never caused a leak.)

My main concern now is that Coloplast makes so few Mio models without the filter. The model I'm using (10492) can be found on Coloplast's US website but not their Canadian website. And it seems that Coloplast's websites for some countries don't include any non-filtered Mio models at all. I hope they keep making the non-filtered pouches I'm using.

Posted by: Bob

 On analyzing them, I decided they probably involved pancaking on occasions when my output got thick, and the huge Mio pre-filter may have acted as an obstacle that prevented the thick output from spreading away from the stoma area. So I decided to switch to non-filtered Mio pouches (specifically model 10492, which is identical to 10482 but without the filter). I've been using these non-filtered pouches for more than 7 months now and haven't had any more leaks. Maybe it's too soon to be absolutely certain, but it looks like I've solved the problem.

Thanks for sharing that, Bob! Glad it's been working for you!

Eric, you wrote that you'll get leaks due to ballooning but not pancaking.

I should add that most of my leaks are from ballooning at night, but pancaking has probably been responsible for several leaks, I'm sure. That said, I can't even recall the last time I actually had a leak. My appliance (2pc Hollister w/ CeraPlus) has been extremely reliable. 

My main concern now is that Coloplast makes so few Mio models without the filter. The model I'm using (10492) can be found on Coloplast's US website but not their Canadian website. And it seems that Coloplast's websites for some countries don't include any non-filtered Mio models at all. I hope they keep making the non-filtered pouches I'm using.

I can only guess that filtered models are more popular, even if they don't work for everyone. 

If you are feeling adventurous, you CAN cut out the large pre-filter from the Mio bags, and then put a sticker over the outside of the filter from the outside of the bag - it's a bit of work to do this, so it's not a very long-term solution. 

Eric, thank you for replying so quickly! You wrote: "I can only guess that filtered models are more popular, even if they don’t work for everyone."

Well, Coloplast has been promoting their full-circle filter very strongly. See their video at https://www.coloplast.us/global/ostomy/convex-launch/convex-innovation/?section=The-pre-filter-is-the-key_391002 And they seem to think it's such a great innovation that they're putting it in nearly every Mio model. It's possible that this pre-filter is causing problems for a lot of people who have no idea that it's a problem. Sometimes it's pretty obvious, as in Gail's case below. It wasn't so obvious in my case. I was getting occasional major leaks for no apparent reason, which was very frustrating. Finally, I figured out that my leaks seemed to be related to pancaking caused by the Mio pre-filter.

You also wrote: "If you are feeling adventurous, you CAN cut out the large pre-filter from the Mio bags, and then put a sticker over the outside of the filter from the outside of the bag"

Since I had saved one of the filtered Mio pouches that I used to use, I've examined it to see if this would be possible. I decided that with the 1pc model I used, it wouldn't be possible to cut out the pre-filter without destroying the pouch. But it might be possible with a 2pc.