Leaks, Pain and Itching 4 weeks out

[clover5]

I had colostomy, rectal prolapse and anal closure surgery a little over 4 weeks ago... my stoma is nearly flat and oval and I have a small but not flat belly. I am using Hollister supplies. A couple questions:

1. Been struggling to get a good seal so that output does leak under and around stoma on to skin. I switched to a Convex wafer with a snug barrier ring wrapped around the stoma and have added a belt to keep it snug. Finally today for the first time I changed and there was no leakage out onto my skin. I only let it go 2 days and was feeling itching and some pain but obviously that was not from output. My question is at 4 weeks did you still feel pain around your stoma edges? Could the itching be from the adhesive or healing skin?

2. Was thinking to try the Hollister oval convex barrier ring but not sure its that much better than the standard Adapt barrier ring. Has anyone used them and has it helped solve leakages?

3. Like to not have to use the barrier rings or belts but with a flat stoma on a not flat belly am guessing it may just be something I have to deal with. If your in my situation have you been able to find a minimal solution or should I just adapt to what it is.

4. My anus is closed after about 1.5" and has some mucus. I feel pain around anus still especially after sitting on it for awhile. I know that area is very sensitive and takes a long time to heal... am going to Dr next week to check it out. How long did it take for your anal area to heal and stop hurting?

I've ordered more samples from ColoPlast, Hollister and Convatec, hoping some combination will make this simple and easy.

[ot dave]

Hi clover,

You are on the right path with using the convex flanges and a barrier ring. Itching is a sign of skin healing. So if you're now keeping the area clean and free of output, you'll likely get some of that uncomfortable itching. I get it on parts of the skin under the flange that never see output (around the outer edges), as that skin heals too, after removing flanges. Just part of the deal.
I don't use convex flanges, so I can't really offer any advice on their use. My mantra is if it works, GREAT! If not, try something else.
As a colostomate, one thing I would highly recommend is that you look into irrigation. Irrigation would significantly reduce, if not eliminate uncontrolled output. I irrigate daily, and routinely get 24 hours without output from my colostomy. With immodium and diet changes, I can easily go 48 hours if needed. Check out the irrigation board and read the "sticky notes" at the top and ask questions. We love new "gaters"!
I had a total APR, so my anus and rectum were both completely removed. It took every bit of 8 weeks for the perineal area to heal before I went back to work, and even after that I "still tread lightly" for another 4-6 weeks. However, healing is different and unique for each individual. Just remember that it is a marathon, not a sprint.
Hope that helps some.

David

[carl4grace]

I'm a newbie. Urostomy 4/4/19.

"Karen/Button" has some good tips in the following post:
viewtopic.php?f=2&t=26737&p=225329#p225329

Carl

[clover5]

David,

Thanks so much, the encouragement really helps. I have been reading about irrigation and it’s on my long term plan to try. Right now 95% of my output happens overnight and I have had to change bags at night a couple times. My output doesn’t at all seem commensurate with my intake though I don’t feel Constipated. I am not sure if that makes me a good candidate for irrigation or not

I had a blockage a few weeks ago that ended up at the hospital overnight with an NG tube so am very committed to not going through that again. Was reading that they sometimes use irrigation to clear blockages so want to have it on hand regardless.

Clover5

Hi clover,

You are on the right path with using the convex flanges and a barrier ring. Itching is a sign of skin healing. So if you're now keeping the area clean and free of output, you'll likely get some of that uncomfortable itching. I get it on parts of the skin under the flange that never see output (around the outer edges), as that skin heals too, after removing flanges. Just part of the deal.
I don't use convex flanges, so I can't really offer any advice on their use. My mantra is if it works, GREAT! If not, try something else.
As a colostomate, one thing I would highly recommend is that you look into irrigation. Irrigation would significantly reduce, if not eliminate uncontrolled output. I irrigate daily, and routinely get 24 hours without output from my colostomy. With immodium and diet changes, I can easily go 48 hours if needed. Check out the irrigation board and read the "sticky notes" at the top and ask questions. We love new "gaters"!
I had a total APR, so my anus and rectum were both completely removed. It took every bit of 8 weeks for the perineal area to heal before I went back to work, and even after that I "still tread lightly" for another 4-6 weeks. However, healing is different and unique for each individual. Just remember that it is a marathon, not a sprint.
Hope that helps some.

David

[clover5]

I'm a newbie. Urostomy 4/4/19.

"Karen/Button" has some good tips in the following post:
viewtopic.php?f=2&t=26737&p=225329#p225329

Carl

Thanks Carl, just read and it has great info.

[smashms]

first off you are still very new to the game leaks and pain are bound to happen this early. take it easy still as you just had major surgery it can take up to a year to fully heal. as far as leaks go try every manufacturer out there they will all send samples to you for free. also take advantage of their nurse reps as they can sometimes help solve problems before they become real problems. and also make sure you are drinking enough fluids as this can be the cause of blockages as well as not chewing your food enough. the itching may mean you are allergic to something in the wafer.

[AJM]

I had a challenging time finding the right solution for me. I also have a flat, oval stoma on a non-flat belly, and the opening points down right into a dip in my skin, so it was pretty messy all the time and my skin was becoming irritated.

After weeks of trying just about every manufacturer and option, what I finally found that is working extremely well for me is Hollister Soft Flex - they are made for frequent changes, and I now change twice per day. They fit well, the material is very flexible so there are no gaps, I have had no leaks or issues, and I don't mind the frequent changes as it keeps me from any skin irritation (plus I always feel clean and comfortable). These have worked perfectly for me. I also use the Safe N Simple peristomal wipes which are convenient and leave no residue, they are great. I had pain and tenderness around my stoma until I was about 6 weeks post-surgery, and then it was totally fine.

As other posters have mentioned, the manufacturers will send tons of samples. It is really just trial and error, keep trying things until you find what works best for you. I wish you the best!!

Andrea

[steiconi]

Is the skin under the wafer irritated, especially with tiny red dots? That can be a yeast infection, which will cause itching and contribute to leaks. Doctor or ostomy nurse can diagnose it and prescribe medication.

I'll second the suggestion to irrigate, it gives you back control. Many people irrigate in the morning, but you might want to try it before bed, since that's your current timing.

Irrigation forum at viewforum.php?f=12