Hi Lisa,  I have a loop ileo too, and mine is a kind of imperfect oval shape.  It has taken me a while to figure out how to cut the hole in the flange to fit properly and I don't always get it right.  My second hole is also very close to the skin, but it has not caused me any problems, so I guess I'm lucky.  I wear a one piece soft convex Hollister and I don't use any barrier ring. The product number is 8958.  The flange on this product has ceramide in it which protects your skin. I have found that this appliance works better for me than any other.  I warm the flange with my hair dryer after taking the backing off, for about 30 seconds and then apply.  I hold it firmly in place for a good two minutes.  I think these two steps are really important because I was not getting such a good seal and good wear time before.  I have not had good luck with Coloplast appliances and was constantly getting leaks.  I get a good five day wear time and my skin is usually in pretty good shape afterwards, unless I've messed up with my cutting and a bit of output manages to irritate my skin, but it's never actually gotten under the flange and compromised it. Another point, I don't use skin prep and do always shower with soap and lots of water to rinse before changing, and of course make sure the skin around my stoma is really dry.  Our situations sound similar so I hope this helps.  I know we are all different though.  My output is all over the map throughout the day, sometimes quite thick, then sometimes very loose.  

Good luck,

Terry

p.s. On the subject of loop versus end ileo, I've decided to stay with my loop as it's working well for me, and another surgery for an end just seems like a risk I don't need to take.  Surgery always comes with risk.  I hope you can find a way to make this work for you.

The mushroom top stoma can fool you into making your base hole too large. I was doing that for some time and having unpredictable wear times. I changed from a 25mm hole to 20mm. Usually means squishing the stoma through the hole a bit. But then it fits well round the base. I have no issues with irritation due to the close fit. Some might. Or other appliances might be harder at the edges.

This means I also need to be extra careful not to get stoma juice all under the base. It is quite slippery stuff and I think it really ruins the seal before the base and or ring can expand well. I have a stack of pre torn paper towel sheets at hand. After washing and drying I keep paper towel round the stoma to sop up the juice. The towel will stick by itself while I peel the base. At the last moment, off comes the paper towel, grab another sheet for a last dry and I squish the stoma through the base while it is dry as possible.

I use Ivory soap. No extra stuff in it. I will spray adhesive remover all round the area and always seem to get a bit more off, even after hot shower and soapy wash. Then have to be sure all that is gone too.

As all have said. Dry, dry, dry, skin. I suppose there is little I can say that you don't already know. You have more experience. But you never know. Maybe some hint in there.

I made a little device to help me. It is just a tube sized to my stoma, with a flange at the bottom. It fits just inside the Mio Click bag ring. After applying, I slip it over the stoma and press real hard for a while. I often hear/feel some air come out from under the base when I do this. Just a bit. But maybe that is the difference to a good seal. I used to try and press down around the stoma with various things. But it was dicey. Too easy to cause some damage.

@chrisandbagpus 

Chris- the gang-planking term totally makes sense. I rarely sleep on my left side because with my stoma on that side and a memory foam mattress, I worry about gang-planking my wafer loose. 

The first time I tried different samples, the sensura mio 2 piece was the best, but maybe I need to try samples of others again. I just really like everything about the sensura mio bags. They are a good material and easy to empty. 

Your two ring method sounds interesting. It is as if the second ring is providing the convexity you are missing using a flat wafer??  Very clever and great that it is working for you. 

Thanks for sharing your research with me. 😊

@varg55 

Thanks Terry!  I hope I can get to the point where my loop ileostomy isn’t a problem for me too. Do you get output from the second hole?  I don’t know if the leaks are more caused by the second hole or by the crease in my skin, especially when I bend over. They are pretty much the same spot. Actually I think it is probably a combo of both. 

Thanks for telling me what you are using. I think I will call Hollister and ask for a sample of it. 😊

@kedikat 

Thanks kedicat. The edge of my wafer is hard and my stoma is easily irritated. But I have been butting it a bit larger and pushing the edge of the ring through the hole and that protects the stoma from getting scraped by the wafer. 

It is tricky not to let anything touch the stoma. I’ve had to replace the extra little piece of ring I put in the crease in my skin several times because it accidentally touches my stoma and then won’t stick because it gets wet. 

How did you make your device? Can you post a picture of it?  I started out using a q-tip but a couple times it slipped through the wafer opening, which was painful and caused bleeding. Now I just wrap a gauze around my finger and push down to try to secure the wafer. I get that same squishing noise or air coming out sometimes. 

Liza

In your reply to kedicat

you mentioned "it accidentally touches my stoma and then won’t stick because it gets wet. "

I have read about the Karaya powder. It states somewhere that this power can be place around the stoma after wafer to provide a liquid proof seal in the gap between stoma and the hole size in ring, apparently it swells under contact with liquid.

Anyone have any info on this as its not so popular?

I also find overall the mio bag the best product for me the ring filter under performs to their claim so I cut half of it away!

The reason the Holister convex barrier ring works is because of its small overall diameter and allows more sticking area of the wafer to work, as I cant see if the Brava ring is stuck down without any seepage. The extra barrier ring is to ensure I have a good contact and adhesion close to the stoma before I place the bag and convex ring on. If I attach both to the wafer liquid can seep under causing a sore. So my method gives me the best alignment and adhesion of all three components. there isn't a convex bag or wafer that has a smaller enough diameter or flexing for my stoma position - too close to the scar tissue!

@chrisandbagpus Good one Chris!!! Pirates of the Caribbean!!! I love that and the pirate plank too! It's always wise to re-think products we use when issues arise & trying different ones so you have a back up incase an issue arrives that can't be solved with the usual products used. Having a "go to" for the "just incase" kind of thing! I haven't used them in ages but I keep rings on hand incase I need them in the future.. . Lol, and that has happened ! Ugh!  

Chris, You & Tony have a great way with words & your input about our output, hehe,  here has been appreciated time & again. 

I'm so impressed the way everyone has come forward to help Liza thru this difficult challenging situation! 

Liza, any improvement on the leaks?? You are so close to your trip! I'm so excited for you & very happily envious too!! Lol! I can almost feel the sand between my toes!  

I want to make a few suggestion for you. One thing I've learned to do with my drippy stoma is to wrap some TP around it. Now, I know your stoma is pretty much flush so thats not much help for you. But...have you tried having a stack of 2 squares of TP handy & slapping them on your stoma while you prep your skin? 

I just had a 5 a.m. change because my wafer split across the top L. section towards the side edge. As it was very quiet in the house at that hour,  I noticed that after 8 Adhesive remover pads I could "hear" the change in moving the wipe across my skin. It literally "sounded" squeaky clean.  This is something I've  only felt before. On that note it did not sound the same in the 1/2 inch around my stoma so I used more to clean that area by adding the adhesive remover spray to the wipe & cleaned a 1/4 of the circle around my stoma at a time, (mine is actually still downward D shape), I used a further 6 wipes until I heard the difference there. Then 2 more until I was 100% certain I had a clean slate. 

Then I washed the skin with just clear water using a 2 inch piece of towel. I'm still cutting squares of bar towels from the $ store,  lol, its cheaper for me & 2 towels go a long way.  Yes, I toss used squares.  Some here prefer gauze which is great too. Then because my skin was raw in a few places I used a double layer of the Skin Barrier Spray around the stoma.  Drying it with the blow dryer. I feel stoma powder tho it has its need,  was causing leaky issues for me. I rarely use it now.   

This is where using TP to absorb the fluids the stoma makes comes in handy. Because tissue sheds in layers I buy 3 ply toilet paper it doesn't leave pieces on my stoma. My stoma is thankfully a nice 1 1/2 " long &  I'm able to wrap it up with TP tucking it under the bottom edge closest to my skin to hold it in place! For those with longer stomas,  I use 3 squares of TP folded in half then folded in half from kitty corners. I then put the 1st pointed edge under my stoma & wrap up my stoma from there. ( I prep a full roll of tissue at a time then its always ready). This allows me to see the tip of tissue I tuck under the TP at the base around my stoma. This does 2 things makes a spout to keep output off my skin while drying & allows me to actually pull the wrapped stoma with the tissue gently out & off my skin enough to get the spray right where I need it without getting it on my stoma then blowing it dry.   Lolol...before I bought a blow dryer I used a straw to get the air where I needed to be sure it dried perfectly.  This is BEOS, before Eric on screen! Lol! 

To put the pouch on & because my stoma is very wet, I take a square to TP, folded in a triangle then twist it tightly to form a point. I hold the wide end between my teeth until I need it to tuck my stoma into the hole of the pouch. This keeps fluid off my wafer. You can use a Q-Tip with most of the cotton removed,  but make sure its tightly twisted tight between 2 fingers on the little paper stick. Avoid touching the wafer.

I'm so in LOVE with warming the pouch with the blow dryer! What a huge difference that makes in adhesion of the wafer!!   

Liza, my biggest suggestion for you here is before you go, is try changing your pouch asap in the a.m. & start you day with a very clean slate. Hopefully that will buy you several hours before a leak develops to open up time for you to enjoy a whole day! Also if you haven't already, try a squeaky clean time of your skin. No soaps, just Adhesive Remover, water then Barrier Spray. Product build up & rings were my issues when I was dealing with too many leaks, but still  nothing to what your experiencing at all!!! 

Also, travel day, maybe try to avoid eating untill you arrive or almost arrive.  Eat a marshmallow or 2 1st if thats worked for your active stoma changes, who knows maybe it'll hold off output longer. Something thats worked for me when traveling... Hydrate plenty for 2 days before then limit fluids before & during your  flight.  Our flight only served juice, water & peanuts! If you need to eat bring a sandwich that won't smell up the air around you, no tuna! Lol! 

All the best my friend!!! Enjoy some sand time & seashell hunting for me! 

@squeakyandliza Hi Liza,  I do get a little output from my second hole, very little it seems, and it's a sort of clearish liquid.  It's never gotten under the flange and even when I don't cut my flange perfectly and I get a little skin irritation, it's never been irritated right where the second hole is.  I've heard lots of loop ileostomates have problems with leaks where their second hole is, so I guess I'm just lucky.  One other thing I will mention, there have been occasions when I've had to change my appliance without showering with my stoma uncovered.  On those occasions, I've just used plain water, which I know many people do.  I've found, for myself anyway, that I can't really make my skin as dry as it would be after showering with soap and water.  There are always going to be natural oils in your skin that will prevent it from being totally dry.  I've never gotten as good wear time when I've just used plain water.  The driest skin possible is what works for me, also as mentioned by another, just use plain Ivory soap with no scents or other additives.  Do give that Hollister pouch a try and let me know how you make out.  Good luck!

Terry

Liza... you talked about  trip to your Moms & that you had no leaks during that time even with traveling in the car & all the water activities. Question...does your seat belt rest on top of your pouch area at all?? 

I'm thinking the difference here is perhaps "seat belt pressure". There is  one thing I don't do anymore, mostly because of the extreme anemia fatigue & the business with caring for Gwen a few days a week.

For years I continually needed to lay down after a pouch change with a warm hot water bottle over the top of my wafer area. I protected my stoma with a wash cloth then placed the water bottle on top of that and spent 20 to 30 min. laying down & resting.

Between the heat of the water bottle and the pressure,  it gave me the seal I needed to wear a pouch for at least 7 days.

During the 7 days wear time I would be doing all my own housework, laundry,  shopping & weeding & caring for my vegetable & flower gardens, walking my pup & grooming him (Romeo rip) ...with no leaks. 

 On realizing this as a possible cause of my more frequent leaks because of the lesser grade bags we are now sent...I know I'll  be reinstating this aqain as part of my pouch changing process.

It might just be worth it for you to give this a try.

Chris,

I meant to say I rarely sleep on my right side, mostly I sleep on my back or my left side. I just noticed that mistake and too late to edit my response. 🤣

@squeakyandliza 

It's a very basic gadget. Made it on my 3D printer. I will make another one with a smaller opening, now that I am using a smaller hole in the base. Also a flange on the other end as well to make pressing easier. Luckily the Sensura Mio base has a pre cut 20mm model that seems to be perfect for me so far. No more cutting the base. Not sure if the picture will show up. Just attaching the file.

@kedikat 

Thanks for sharing the picture. That is very cool. Just out of curiosity, how long does it take your 3D printer to make it?  I don’t really understand how 3D printers work. 

So is the ring just smaller than the ring on the wafer so it fits in the wafer without touching the stoma?  What a clever idea!!

@kedikat That's really clever! I was fortunate enough with my 35mm cut opening, to find a PVC fitting that works perfect for getting everything stuck down.

@squeakyandliza 

I can't remember how long that took to print. Probably an hour? Not a lot of material in that thing.

A 3D printer like mine works by melting a thin string of plastic that feeds out of a heated nozzle. The nozzle moves back and forth controlled by a program that converts a drawing of the item into vertical slices of the item. After one layer/slice of the item is created, the nozzle moves up a slight amount and then deposits another layer and so on till it is done. Like laying bricks to construct a wall. There are other methods of printing solid objects. But they all follow the same basic scheme. Building an object in vertical layers. I have built a few other things. Drone motor mounts, battery boxes... I am pondering making a stoma guard that fits within the Sensura Mio bag attachment ring. So I can go back to my Levi jeans.

Yes the wider part fits between my stoma and the inside of the bag attachment ring. The gadget just makes it very easy to get a good firm pressure all round the stoma to seal up the wafer edges. I suppose. It does help. As I mentioned, I do hear/feel air being expelled. It is also very easy to keep the pressure on for any length of time you have patience for.

Now that I have settled on a 20mm hole size, I will print another one to fit closer to my stoma.

I have been considering making this gadget for other folks. Not sure if folks care to bother having one.

If I do build the stoma guard and it works, I may put that out there as a file for people with a printer. Or maybe sell to those who do not have access to a printer. Busy with a lot of stuff right now. Renewing my roof and busy at work. But will get to it soon.

@kedikat

That is fascinating. I had no idea how 3D printers worked. If you did start making those devices to sell, I would buy one. 😊

@squeakyandliza 

As I and GoatHerder mentioned. You may be able to find a suitable device at the hardware store. Maybe even something about the house. Use your imagination.

One could even fashion such a thing out of various hobby materials. Stuff that can be molded then hardens. Much cheaper and easier for the average person than a 3D print scheme. I just happen to have one.