Ileostomy Wafer Leaking

[wiljpeters]

I'm at my wits end. I've had issues but now I'm having leaks and afraid to leave my house. This is problematic since I'm starting a new job in a few days.

I've had my ileostomy since 25 January. I use the 2 piece convatec mio sensura concave system. I've been using the ring and the paste since I have a dip under my stoma. I'm not sure what to do anymore. I no longer have home care ostomy nurse visits. I was discharged from that about 3 weeks ago as I was planning on a reversal on 28 March. However, an exam found more cancer so the reversal is off till May.

I've had many issues with skin degradation which appear to be getting better. The issue is now I've had two leaks in public within 3 days of each other. The first was a full "blowout" walking out of the gym as I was talking to someone. It was completely devastating and demoralizing. Then last evening I went out to happy hour with friends (I was drinking diet soda). I thought I started to feel something odd and then had a sharp pain... I literally ran out of the bar and by the time I got to the car i could see it was about to blow out again..

I'm an active person but I don't think it's my physical activity. I'm trying to wear "normal" clothes more as I prepare for going back to work. I have no idea what to do anymore. Anyone else have these issues? Please help.

[Fkross1967]

I have only had my iliostomy for one month. The first week I was having so many problems with my bag falling off.

What has worked for me on both a one and two piece bag is as follows:

1. Make sure skin is completely dry. I use a paper towel to wipe off any moisture around and on the stoma.
2. I use a barrier ring and then i put a ring of paste around the barrier ring. I use a hair dryer for about 20 seconds on the ring and barrier after i have attached them to the bag.
3. After attaching the bag to my body, i then cut a Strip of KT TAPE (used by athlete's and can be purchased at pharmacies, Walmart etc) into 4 strips and place them around the adhesive of the bag to hold bag onto skin.

This procedure has worked every time i have had to change bags. I am able to wear the bag 3-4 days between changes. I think the KT Tape is the step that is most likely what holds the bag in place.

[NEskier]

A few thoughts: Convatec and Mio - Convatec is a manufacturer. Mio is a product not manufactured my Convatec ... so not sure what you are using.

You mention using paste: are you aware that paste is not sticky? As in paste does not increase adhesion? Paste is best used as a filler for cracks or uneven surfaces.

What many of us learn is 'less is more'. Try just the flange/pouch system without the addition products. Make sure your skin is clean and dry. I, for one. pull my system off and shower with a non scented, or lotion included soap. Cetaphil works for me and some others. And then make sure it is totally clean and dry before you apply the pouch. I put TP around the stoma while I'm getting ready. And tend to shower in the morning with 8 - 12 hours since the last meal to lower output.

I hope this helps and you fight off the cancer. No fun fighting both at the same time.

[Rchodos1]

When you are changing make sure the soap you use contains NO oil. Ivory or Dial is my soap of choice. Check out Cavelon 3M , a product I use for better adherence. Best of luck

[steiconi]

Paste is a waste.

Try cutting off a bit of the ring to fill in your crease.
Isn't the mio a soft and flexible wafer? You might not even need a ring.

[retired tracye]

Just a couple thoughts... I have short gut syndrome so constant liquid high output... Change your pouch frequently... I change mine every other day no matter what, some times every day... I have not had a blow out since I started changing it so often. Never let your pouch get more than 1/3 full, that takes the pressure off of the stoma are and the wafer. I know I am high output but I rarely go more than an hour without emptying it. I wear maternity pants... this allows for no waste bank cutting though the middle of my pouch and allows the pouch plenty of space with no pressure. I use to suffer from skin abrasion around my stoma... first I learned about crusting, the building up of stoma powder around the stoma, also ... I use the Coloplast Brava 4" protective sheets instead of a ring... I cut them in quarters, so they are 1" x 1" then I cut a whole in the sheet that is smaller than the hole around my stoma... this keeps my skin covered and protected.. but if I go more than two days on a pouch, this material will break down and I get skin deterioration and bleeding. I hope something here gives you some relief... good luck at work. Tracye

[Diane C]

Concur with retired tracye that Brava is a great product. Unfortunately, if I wear Brava strips, my skin reacts after a few days so I need to rotate. I also like Ease strips by Convatec. Our support group held a small appliance fair and the Convatec rep advised heating these with a hair dryer before using them around the wafer and on the skin.

I also use the Durahesive material from the hole that I cut (if the wafer isn't pre-cut) and really like Convatec's Stomahesive strips to fill in gaps and crevices. Yes, it's sticky. I fold over a small amount, put it on my skin, and place a wafer over it.

I'm still dealing with some leakage but don't change my wafer daily. Usually every 3 days. I may swith products... it's time to order. Hoping I hear from Cymed MicroSkin soon as I received an email indicating the company would be in contact several days ago.

Diane C.

[JerryNYC]

I frankly could not survive without a base spray of "Cavilon No-Sting Barrier". I use it after I have removed my old wafer and pouch and use adhesive remover and then soap to clean the area around the stoma. After drying the skin (a hair dryer is helpful) I spray the skin around the stoma with the Cavilon and then give it a second spray a couple of minutes later. I then use Hollister Adapt rings around the stoma (although a lot of other rings work as well). I found that pastes usually break down in a couple of days. I then apply the wafer. At this point, I put on ALP "Sure Seal Rings" which help hold down the wafer (especially during showering or swimming). The pouch goes on last. I usually last a week in between changes. Hang in! It's always tough early on but things will get better.

[agichk]

Thank you guys for the ideas.

wiljpeters: I am really sorry to hear about the bag failures so quickly and in the situations you mentioned. I would have the same the feelings if i had this too.
I would encourage you to see an ostomy nurse as they maybe able to really help you so this won't happen again. Please post what you found worked best for you after the 2 bag failures. I am interested to know as I had my first leakage 9 weeks after surgery.
I had my first leakage last Monday night and I was surprised to wake up to it when I had just changed the bag the day before. I was glad it was at home but really frustrated too. I am going back to work in 2 weeks though from home and really not sure what to do when I do go back to the office.

Have the doctors given you a new date for reversal yet? I am wishing you the best with the treatment for the cancer and prayers that all goes as well as possible so you will be cancer free as soon as possible. A friend who uses the stomahesive, which I can't seem to grasp the concept of as not taught, is a 33 1/2 year colon cancer stage 4 survivor after almost no chance of survival after surgery was successful. Never give up hope.

I have found that the cololplast semi circle or even the straight i guess barrier rings maybe helpful with summer and heat coming. I found the barrier or wafer is peeling up on the side closest to wound vac, which I suspect is due to every other day changes and them using release spray to start removing dressing. Now that I have had allergy to the adhesive, KCI other dressing is 3M tegaderm and usually can get started w/o spray if I can beat them to it.

Kathleen