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THE AMAZING CONVEX SYSTEM  

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Reggie Jones
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August 20, 2019 5:21 pm  

Wow, I stumbled across using mild convex pouches about 8 months ago when I had a very brief visit with an ostomy nurse who gave me a few of the coloplast sensura mio mild convex cut to fit.  I was using Holister one piece, just flat, and it would leak in 2-3 days, well at least it would get under, not actually leak as most of the time I caught it before it actually breached the barrier.  Wonder of all wonders I now can go days and no hint of a leak!  I highly recommend for those struggling with leaks and not thinking they are candidates for a convex to get some samples and give it a shot.  Like me I thought, "What have I got to lose?"  and it worked..  God bless and hope someone benefits from this post.


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IleosTony
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August 20, 2019 5:49 pm  

Hi Reggie,

 

Wonderful, isn't it? There' s just no substitute for the peace of mind that comes with discovering a pouching system that you can rely on. I'm really happy for you! Thank you for sharing your news and this tip.

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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sjlovestosing
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August 20, 2019 6:00 pm  

Hello Reggie,

How I love to hear success stories! I also use the SenSura Mio Convex and have enjoyed the security and freedom it has given me.

Stella


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VeganOstomy
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August 20, 2019 7:18 pm  

That's wonderful! Thank you for sharing! 

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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SqueakyandLiza
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August 20, 2019 8:27 pm  

That is what I am using too, though I am still struggling with leaks. I'm glad it is working so well for others. 


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Dona
 Dona
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August 21, 2019 10:00 am  

Reggie,

Thanks for sharing. It really will be a help to people! Many people don't know about the convex type of wafer. 

I started using convex wafer about three years ago after experiencing leaks just like you described.  I use the Hollister brand still, but switched to the convex wafers. Problem solved. 

Trying to deal with those leaks is what brought me to VeganOstomy, so I can be thankful for that too.

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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john68
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August 21, 2019 10:42 am  

Always great to hear of success and the peace of mind that comes with it. Eric fixes more leaks than a plumber 🔧🚽

ileostomy 31st August 1994 for Crohns


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richard
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August 21, 2019 11:51 pm  

Thanks Reggie. I might look into that option.  After two years of hardly a leak--once that I recall--a recent stoma revision has left me in a precarious position resulting in constant leaks caused by (my assessment with input from ostomy nurse and home nurses) "pancaking" and resulting undermining of the barrier, with or without barrier rings.  A Hollister one piece convex was a disaster (lasted maybe 16 hours without a leak). Stoma paste has helped some when combined with the Hollister New Image flat barrier, but I am experimenting now with a rigid convex barrier (no rings or paste) also from Hollister that is working so far (first trial underway and I am nearly three days leak free--currently, that is a bit of a miracle, though four days without thinking twice about it was my norm for two years prior to the revision). I also have peristomal skin problems, made worse by chemo drugs, and thus seem to need Ceramide impregnated barriers. I have to admit that I am hating the revised stoma and desperate to find an ostomy solution that gives me back leak-free performance and piece of mind to go about my life--pretty much afraid to leave the house at this point given the frequency of failure recently. 


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john68
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August 22, 2019 4:24 am  

Hi Richard, Welcome to the forum, what has changed with the stoma, was it more protruding before and now flush, the convex seems to be a winner for the flush stoma.

ileostomy 31st August 1994 for Crohns


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SqueakyandLiza
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August 22, 2019 10:10 am  

@richard

Hi Richard. I can relate to what you are going through. I've been going through a bad string of leaks lately. I'm not sure why, but am getting them daily. 

I use a coloplast convex bag, and also use paste. That was working okay for a while, but lately it seems like a similar problem to what you are describing--pancaking and leaving output no place to go, but to breach the wafer. Or else I think my constantly trying to massage the output down into the bag is weakening the seal. 

I will be watching this topic to see what suggestions you get. Oh, and my stoma is flush or even recessed a little, and opens to the side, so I'm sure that adds to my trouble. 

Liza


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richard
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August 22, 2019 11:17 pm  

@squeakyandliza

Thanks. I am happy to share, but I think much of it will be redundant with the good advice already on here. I am sorry you are going through this and hope you can solve it soon. I can add my experiences and impressions as both an ostomy patient and as an engineer.  Sometimes, the latter makes me laugh at suggestions given, but sometimes I am wrong, too. My revised stoma is short, though not recessed (just a bit above the skin), but also opens to the side (9' o'clock if you are looking at me). The new barrier (Hollister 11402--rigid convex with Ceramide) seems to work OK (no rings, not paste--I have a theory that these weaken the seal all other things being equal) and lasted three full days with no leaks. I do not want to get excited after one test, but this is huge compared to my last one month of daily leaks.  Pancaking is now reduced. I have followed advice of adding lubricant after most every emptying (depends on what I just ate or drink or plan to--no need of it was just cereal and milk with OJ coming, but pasta, yes), have worked harder at pushing the output down (as you stated), and have tried to increase fluids. The latter one is is controversial in my house. I think I am well into the sweet spot of hydration, and success cannot depend (sustainably) on whether I consume 1,700 or 1,800 ml a day (here is where the engineer scoffs), because the difference is too small compared to the larger extremes of drinking nothing (maybe 500 ml) and peeing all day (2,000 ml or more). I have noticed though that a little beer or wine helps--moves things along with some fluid behind it. I open the pouch and remove anything sticking when I notice a problem developing, no more than once a day.  I have tried to sleep more upright using pillows and such, not sure that helps. More walking and other activity also seems to help; more upright, more help from gravity. Importantly, my revised stoma seems to be kind of oval, but my ostomy nurse reminded me that the small intestine is basically round in cross section. Thus, she encouraged me (and my wife, who usually places the barrier) to stretch the skin and such to permit a roundish cut to the barrier (mine had been more ovalish since late June). The oval shape weakens adhesion, however, as output can more easily work its way under the larger radii.  I hope some of this is useful and am happy to share more observations as they emerge. 


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john68
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August 23, 2019 11:49 am  

Hi Richard, Stretching the skin is not a good idea it can cause all sorts of skin problems. Even putting a wafer on sitting down the skin will be stretched when standing up. Not all stoma are round, mine is oval and with some measurements have made a template to suit. Getting a good fitting wafer is a big step to leak free and healthy skin 

ileostomy 31st August 1994 for Crohns


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VeganOstomy
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August 23, 2019 1:29 pm  

@john68

I have to agree with John here re: stretching the skin will cause "mechanical irritation", which you may notice around the edge of the wafer as skin is tugged on. 

Standing while applying the wafer tends to provide the best results, but don't stretch anything while you're standing or else the skin under your wafer will pull in uncomfortable ways. 

But, everyone may have a different experience due to the appliance they're using, activity level, body weight, etc. Your mileage may vary :) 

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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SqueakyandLiza
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August 23, 2019 7:35 pm  

@richard

Thanks for your comments, Richard. My stoma is more of an oval too and I have been cutting the wafers as such. My stoma opens to 3:00 if you are looking at me, but I also have a mucus fistula that is at 9:00 which also has output so I am getting it from both sides.  I have tried not using paste but my skin has too many wrinkles and creases, partly due to a still unhealed wound that not using paste pretty much guarantees me a leak. 

My husband is an engineer too, so always has some crazy opinion or solution. 🤓 No offense intended. 😂


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richard
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August 24, 2019 12:15 am  

@john68

Stretching is perhaps not the right word.  What she meant was to make sure the contours of the stoma proper are being covered by the skin barrier, and not the contours as influenced by gravity.  So far, and she has nearly two decades of experience at this, she has proven to be quite right.  Typically, I apply the barrier lying down, sometimes standing up (usually in hotel rooms when on travel).  I agree that sitting down is not good, and have only done that maybe once ever and did not like the results. 


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richard
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August 24, 2019 12:33 am  

@squeakyandliza

No offense taken.  I assume you have tried barrier rings, and that they have not worked and thus you have gone to paste.  With the old stoma, I always used rings (Hollister 8805, I think it is), and they worked very well to address creases, divots, etc.  With the revision, my anatomy is a bit different in contours, and quite honestly I am somewhat shocked that the rigid converse barriers are working better (meaning no leaks for longer) on their own than other systems with rings or paste. My wife and I still see what we perceive as divots but remarkably no leaks. I also forgot one more thing my ostomy nurse mentioned in my earlier message: she called it getting some air into the system, by which she meant ensuring that the top and bottom layers of the pouch are not stuck together.  I got it immediately using Hollister beige bags, because there are two layers of material on both sides, one the beige, privacy bit and the other the plastic layer, and these two inner layers have often stuck together for me.  I have worked harder the last week to keep some space between them, and this appears to have helped eliminate pancaking.  That said, I have been in no mood to experiment with one adjustment at a time so I am not 100% sure which new thing I am doing is having the best effect. I doubt it is extra hydration per my earlier discussion of this (the differences between normal and more are trivial).  I doubt it is more frequent application of lubricant, because the latter applications (those with emptying as opposed to system changes) never really make it to the upper area of the pouch. I think wearing the Holllister belt tighter might be helping a little bit, but the Hollister belts are not that effective as most of you on Hollister will know. Thus, I am left with concluding that the more rigid convex barrier wafer is the main reason behind longer wear now. I am somewhat sorry to conclude that, because I actually do not like the feel of the rigid convex system on my abdomen--too hard and inflexible for my taste.  Beats leaks however. 


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john68
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August 24, 2019 7:24 am  

Hi Richard, sounds like you have a great stoma nurse. A little air in the bag helps beat that vacuum effect which can add to problems, sometimes it can be helpful to block the filter if the appliance has one or put some rolled up toilet paper into the bag.

ileostomy 31st August 1994 for Crohns


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LK
 LK
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August 24, 2019 9:04 am  

Richard, welcome...I have to ask, considering I have learned recently about the Stoma Collars, would this not be something people with a recessed stoma and insistent leaks would benefit from?   Eric? 

I agree, stretching the skin to make it more round would defeat the purpose.  When the stoma is formed, it is also passed thru the abdominal muscle wall, and may further stretch skin that needs time to shrink back naturally causing a whole new set of issues...possible folding of skin, etc.  This is occurs on a different time frame for all.  My stoma is a down facing shape of the capital letter D. I prefer to cut to the shape the opening causing less trauma to the skin and area that  the stoma is attached to for healing.  Richard, considering you had recent revision, you could probably also blame the leaks on swelling to some extent too. I sleep on a slant because of the liquid from my ileostomy, it does make it to the bottom of the bag since, thankfully. Have you tried adding extra fruits (the more watery ones) to your diet, I found when I had pancaking issues, (I really wish we could find another word for that, lol)..when I added melons, and the more watery  fruits fresh and frozen to my diet, it helped tremendously with that issue. An internal attack as well as external. Have you tried a small maintenance dose of prune juice after each meal? lol.  All the best and be well.  

Linda

Linda


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VeganOstomy
(@veganostomy)
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August 24, 2019 2:32 pm  
Posted by: @dlkfiretruck

I have learned recently about the Stoma Collars, would this not be something people with a recessed stoma and insistent leaks would benefit from?   Eric? 

For recessed or flush stomas, you will always nearly want to apply some type of pressure around the stoma. This is usually done by using a convex appliance or even some barrier rings. 

Stoma collars, while they might be useful for some, may not work well with a flush/recessed stoma. I haven't used them with a convex appliance, but it may be possible to use that combination. I would probably avoid using them and opt for a convex appliance first. 

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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SqueakyandLiza
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August 26, 2019 3:35 pm  

Like I said earlier, I am using the Sensura Mio convex, but still getting leaks, basically daily. I'm starting to wonder if the seal is loosening when I move or bend over. The Sunsura Mio seems pretty rigid, but maybe it has to be to provide the convex aspect??  Has anyone used a more flexible convex wafer??


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