Lots of questions, some answers

[hippiewoman]

Hello to all. I have only had my ostomy about 6 months. It is permanent because I had colorectal cancer. This tumor was too close to the rectum, so they just took it out along with about 1/3 of my colon. So that road is closed and a new one is open for business. I have some questions (more to come) that I would love feedback on. Just to get started:
Can you rinse out a one-piece?
My stoma is an outie, but it doesn’t stay that way. It goes in and out. Anybody else’s stoma like that? Any idea why?
I alternate between using powder and spray for skin barrier and not using anything. Is it better to use skin barrier? I sometimes have a problem with the outer part not sticking to my skin when I use the powder and spray.
I don’t understand what they mean by wafer and why do they call it that?
Does anyone have any tips for changing an ostomy bag yourself? My husband has been doing it for me.
I'm looking forward to hearing from you all. I have done some reading here and it is very informative. I really do need support.This "new normal" is sometimes difficult to deal with on my own. I do have some answers of my own as to keeping acceptance and serenity high.

[ot dave]

Hello, and welcome to the boards. I'll give you the best answers I have for your questions.
Yes, you can rinse out a one piece, but it might be tricky...and kind of gross, but there's not a reason I can't think of that would keep you from doing that.

Stomas are formed from you bowels, in this case, your colon. Output moves through the colon with smooth, involuntary muscle contractions. This is called peristalsis. At rest, your stoma will likely be soft and "stick out". When contracting, your stoma will get smaller and harder as the muscles are contracting to move the output along the colon to the stoma. This is absolutely normal, and nothing to worry about.

I am a firm believer that when it comes to flange adhesion, that less is more. I don't use anything under my flange unless absolutely necessary, and there are plenty of situations where applying other products is necessary. I have a dip/divot at the 3:00 position of my stoma that requires the use of a seal (Adapt barrier ring/Eakin Seal). However, when you get an irritation or sore under the flange, powder and skin barrier is necessary. When using powder and skin barrier, you want to make sure to end with the skin barrier. You are essentially making an artificial scab with the powder and spray. When using these, apply the powder, blow off the excess, then apply the skin barrier...cavilon spray is my go to skin barrier. You want to repeat this cycle about 3 times to get a good covering on the irritated site. If you leave exposed powder on your skin, your flange will NOT stick to your skin...imagine trying to use duct tape to hold down the corner of your towel at the beach on the sand...pretty pointless.

The wafer, which I refer to as the flange, is the square part that has the adhesive. On one piece systems, the pouch/bag is attached directly to the flange/wafer. With 2 piece systems, the square part with the adhesive does not have the pouch/bag directly attached until placed on by the ostomate. The pouch is usually attached by an adhesive or "Tupperware" type coupling system.

Changing the bag/pouch is something you definitely need to get comfortable with doing yourself. Independence is key to living the most functional lift you can. There is a ton of experience on these boards, and you'll get a bunch of different suggestions. If you can be more specific about what pouching system you are using, you will get all the tips you can handle!

Now, you have posted this in the irrigation forum which is totally ok, but you'll get more traffic with these types of questions if you post on the general ostomy forum.

With a colostomy. you might be a good candidate for irrigation. If you have questions about that, we can answer those here as well. I irrigate every day, and routinely go all day without any output or the need for changing the pouch on my 2 piece system.

Hope this helps.

David

[steiconi]

When I developed an intolerance to cavilon, an ostomy nurse told me you can use nystatin powder without skin barrier.

Apply the powder, rub it in, then dust it off the surface (I use a paper towel). It works for me; I change my wafer every 5-6 days, and have no problems with sticking.

Definitely consider irrigation. It allows you more control, and prolongs the life of your appliance, meaning fewer leaks.

Use a plastic water bottle to rinse a drainable one-piece (or two-piece). Empty the pouch, then pour in 3-4 ounces of water. Hold the end closed and slosh the water around. Empty and repeat until water is clear, 2 or 3 times.

Start changing the flange/wafer (called that because it's thin like a wafer) yourself. Have your husband coach you.

Changing the wafer made me anxious at first, to the point of sweating and trembling, but now that I'm used to it, it's as scary as brushing my teeth--and takes less time.

You might want to apply while standing up (assuming you can stand), which makes your stomach flatter. Once you're familiar with the process, you can do it sitting down.

I usually put on a wide ostomy belt right after changing, to apply pressure on the flange to make a good seal.

You can do this!