Okay my new improved otosmy method

[ot dave]

That's the thing with Cymed flanges. Convexity isn't an issue. The flange is very flexible....imagine adhesive saran wrap. It will conform to your body and stick really well. No need for a belt or any of the other stuff. Plus it allows all kinds of movements. Order a sample, I think you'll see how it works better if you have one in your hand.

David

[Shamrock4806]

Uh a convex combined with a belt pushes down around the near flush stoma to get it to pop out more and on top of the wafer where it can drain into the bag

The convex has to be somewhat stiff to do this. I bend it horizontally to fit better into the belly fold. Still does the job

Also a thinner belt designed to fit into that belly fold to put maximum pressure on the wafer is required.

I don't see any option like that on their web site.

May be good for someone else though.

Thanks for sharing.

[ot dave]

With these flanges, you don't need to move the stoma. The material is flexible enough to go around the skin of the stoma and stay put. It's not hydrocolloid material. It is like clear medical tape that is used to hold ivs in place. Very thin, very flexible, very sticky. The flange moves with the skin during peristalsis, therefore preventing any output from getting under the flange. No need to "push" the stoma up into the pouch....

Good luck....

[Shamrock4806]

With these flanges, you don't need to move the stoma. The material is flexible enough to go around the skin of the stoma and stay put. It's not hydrocolloid material. It is like clear medical tape that is used to hold ivs in place. Very thin, very flexible, very sticky. The flange moves with the skin during peristalsis, therefore preventing any output from getting under the flange. No need to "push" the stoma up into the pouch....

Good luck....

Oh I see,

Very thin, very flexible, very sticky?

That may work. I'll order a sample.

Thanks.

[Shamrock4806]

Okay I corrected two things.

1: Quit coffee. It might have been lowering the pH of the output and really was acid burning the skin. I don't know but it was painful.

2: I wasn't applying enough of the second layer of paste on both sides where the belly fold occurs. I also was squishing down way to hard and now focusing on creating a wall of paste instead that marries to the flatter wafer.

My last bag on lasted several days and just a small burn spot to the right side.

[Shamrock4806]

Okay update.

Coffee definitely was the problem with my output being so corrosive. Now if I have bile in the morning from fasting all night, it's a yellow syrup instead of black liquid. Burns still occur but only a fraction of the pain they were before.

I have one of those granulomas things which I have been ignoring as the output burns were more severe.

I've cut a slightly bigger hole in my wafer and notched it out to bypass the granuloma.

Also instead of using petroleum jelly on my scar to prevent the adhesive strips from sticking to it, which really didn't work for long. I instead used strips of box cardboard like what the otosmy supplies come in. So we will see how that holds up.

I also delayed a bit putting my belt on just used my hand as light pressure to await the paste to set up a little instead of just squeezing it all out. Let it form more of a wall and not trying to press it to force the wafer to match the body contour.

Anyway I've have been doing 1000% better than before and again I think it was the coffee and just stomach acid coming out. Now I feel as my system is more normal. I should mention I have an high out otosmy and it could be that coffee was responsible.

Oh there is one more improvement I've made, after applying two coats of the Flonase skin protectant and drying well after each coat, I've been lightly dusting the area around the stoma with stoma adhesive and then using blow dryer and clean toilet paper to brush as much off as possible.

This has the effect of making the skin really really dry and also right around the sides of the stoma which often makes my paste wet when trying to press closer.

So we will see how well this holds up and currently getting 5-7 days out of a bag now, but removed this one earlier to address the granuloma and the scar tissue itching.

I've been updating my first post with the improvements to assist others with a similar condition.

[Shamrock4806]

I like the idea of the thin sheet as a wafer and everything more flexible. I don't see how that's going to address my granuloma issue. Perhaps I can notch around it then later cover with paste to protect it?

Coloplast is advertising something like that but then their links all go to existing product lines. So maybe it's something they are still working on?

But the adhesive on that thin wafer needs to be very strong to counter the output, I tried using the protective sheet without paste and it didn't last for more than a few minutes. Output pushed it's way right under it and out.

The problem I see with this new thin.wafer design, assuming a paste or ring isn't needed, is what happens if things don't go well? Like the skin isn't dry enough or there is a weeping burn not properly addressed.

If one just tries slapping an entire wafer on and it's wet, then it's ruined and that's a wafer wasted instead of cheaper paste or a ring.


Maybe a two step process, cut the wafer hole large enough that it sticks to only healthy dry skin. Then inside apply paste to the skin around the stoma.

That might work. But paste hardens up and defeats the purpose of being more flexible.

If a paste that's more like caulk and is more elastic?

Maybe why this stuff is still in beta.
.

[Shamrock4806]

Put a new bag on today, only one day after a fresh bag yesterday. Why? A four hour drive that despite me having the seat as far back as possible, caused shear to occur and torn the paste off the skin. A burn occurred underneath of course but it was nowhere as severe now that I'm off coffee.

I know it was the drive because I've been laying in bed for the last week just chilling and no shear occured although I did drive short distances. Seems prolonged sitting is what caused it.

So this time I weakened the entire wafer, also cut a much larger notch for my granuloma. It did subside quite a bit in just one day, so hopefully from now on it will go away permanently.

I took to placing petroleum jelly soaked toilet paper and filled my belly button and then covered my scar tissue with thin cardboard again like before, it's to protect the barrier strips from grabbing it and causing irritation.

I also need to find a better way than just waterproof tape along the top of my appliance to keep water out during a shower. Water got under my wafer again, although it didn't weaken thing enough this time as I'm using more paste than before.

I'm also allowing more time for the paste to harden up before putting my belt on. I noticed yesterday that the belt was squishing a lot of the paste out and that's not what I need to do here, instead allow the paste to wall up and fill unevenness. The belt im trying to use not so much downward pressure, but to keep things in place better when moving around and sleeping.

The stiff wafer has been causing me plenty of issues, so we will see if my weakening of the entire wafer is going to make an improvement.

So here's to another day in this fight, it's looking good especially since I'm no longer in such pain.

Again I'm documenting this struggle so that others can learn and come up to speed quickly. If something really works out good, then I update my first post to reflect that.

[Shamrock4806]

Another day another bag, I think the stoma powder after the skin protectant and then paste was a bad idea I repeated twice. So this time I didn't do it.

The leak pains are so less intense than what I was experiencing while on coffee. A lot less severe and it's almost like I think I can try to live with the pain, but realize I shouldn't be feeling anything at all for an entire week.

So never put stoma powder down after skin protectant, unless your crusting which means another layer of skin protectant on top.

Yea I know, just thought I'd experiment again.

[Shamrock4806]

Unfreaking believable.

Yep, one day yet another bag change.

What occurred since my wafer hole notch to avoid irritating the granuloma, it naturally shrunk down and of course made a nice hole for output to get under the paste and the barrier strip I was using to protect the skin and it just came loose and started stinging..

So note: If scabs or shrinking granulomas, one likely will have to change the wafer daily.

So this time I just used one layer of no sting paste and the wafer, cut the hole closer to the stoma and on top of what's left of the granuloma. I didn't apply the belt because I think that's what's been causing it. It's on my left side where the strain of the belt pulling down is at it's strongest.

So since the output burning isn't as intense as when I was on coffee, I think I can handle not protecting the skin so much, just using skin protectant (double coat,)

My lengthy two step method was taking entirely too much time anyway. But it was necessary because the burns were much more damaging while on coffee and required more attention ensuring things stuck . Plus I wasn't using antibacterial soap (with conditioner after) on the wounds like I am using now..

So we will see how long this one lasts.

Seems to lasted the night. But usually it's been the next day that issues develop.

Edit: Yep it popped off and leaked. Not enough paste. on sides again. Belt is mandatory.

Belt on top tight, loosened it a bit, wafer irritation subsided.

Pain in my arse. This bag thing. It's like I have no life.

It why I write everything down because my memory isn't doing as well anymore and I need a step by step procedure as to remind myself exactly what to do and not forget something less I lose a bag.

[Shamrock4806]

Okay another bag on yesterday. Granuloma shrunk down some more and developed a small irritation leak so it required a bag change to address before it got worse. Procedure.

Remove, shower with antibacterial soap
Scrape off any extra glue or paste residue with coffee stir stick sideways.
Dry thoroughly and test fit wafer hole.
Rim stoma where paste goes with stoma powder and remove completely with dry toilet paper. It will leave an invisible coat.
Two coats of skin protectant dried thoroughly after each coat.
No sting paste tube around stoma, extra shots on the left and right side for belly fold.
Align wafer correctly and press down gently but firmly, press around stoma through appliance. Hole should not be covered.
Cut strip of light cardboard from package box and coat one side with petroleum jelly and place on scar tissue. Fill belly button hole with jelly soaked toilet paper so it's level. Place a rounded edge square piece of cardboard over belly button and scar tissue.
Extra large barrier strips all around, sealing the top especially. An extra small barrier strip on the bottom covering exposed cardboard and scar tissue.
Put on belt but not too tight, just a gentle pressure down.
Use blow dryer to heat adhesive and warm it up so it activates and adheres to the skin good.
Address fistula with low stick tape and jelly covered by a water proof tape piece to hold in place better. Clean hole if necessary beforehand.

A very professional looking job I may add.

No pain or problems for two days now. But it seems the granuloma has been the source of my latest problems and I'm hoping I can get it under control. Trying a mix of less belt pressure and more accurate wafer application. Hopefully it's not me sleeping on my right side that's causing it. I don't think so because I still am but it has shrunk quite a bit since the larger wafer hole opening and belt loosening. Maybe it will go away.

I am happy again.

[Shamrock4806]

Okay bag change today due to aches, two minor burns one on top and one on the bottom. Used my antacid wash output neutralizer to buy me time so the stoma quit production..very highly recommended than just waiting in the shower for hours.

Same procedure just omitted the petroleum jelly on the scar tissue as it wasn't working.

I'm leaving the belt off while laying down to let the paste harden up a little before placing belt pressure on it thus squeezing out too much paste.

[Shamrock4806]

Okay same problems as before..not getting the 5-7 day wear time like before using the two step process.

I think what's occurring is the belt on my right side is just digging the wafer hole into the skin. I didn't have this issue before when using the protective sheet. So this time I followed my previous two step process and with a few additions.

1: Low level of no sting paste around stoma just to protect the skin.

2: Moon shaped barrier strips all around stoma and ensure stoma has movement upwards by jamming any area of barrier strip next to stoma down.

3: Extra layers of cut barrier strips on my right side where the wafer hole will dig, thus raising height as to hopefully take any pressure off of granuloma which is still there but just a small barely noticable blemish now that I've been using a wafer notch.

4: Plenty of alcohol paste around on top to marry wafer too, extra on the right side to cover granuloma wafer notch with belly fold and left side for belly fold.

5: Olive oil based skin moisturizer on scar tissue, belly button filled with tp, covered with thin cardboard pieces like before.

6: Wafer on. Softened horizontally first. Extra barrier strips all around. All barrier strips blow dried to activate when applied.

7: Leaving the belt off for some time to allow paste to harden up some..but putting some pressure down to ensure a good bonding. Just don't want to squeeze out paste. Maybe I'll put the belt on with low tension.

Really eating up the barrier strips with this method, but if I'm changing the bag every other day due to leaks and irritation then it's a bigger loss. Need to get to a 5-7 bag wear time again like before.

And I slug on.

[Shamrock4806]

Uh, blowout 4 am.

Seems my granuloma issue is caused by leaning on my right side. So I slept the night with a pillow under my right butt cheek to elevate it a little and the pain seemed to go away, but in the middle of the night I rolled on my left side and that just busted the paste seal good, like it always does. The barrier strips caught most of it, but a tiny gap at the top leaked onto the bedsheets.

Taking the bag off I noticed adhesion wasn't very good.

I replaced the whole mess with the traditional paste and wafer, omitted conditioner around the stoma and skin protectant further out from stoma, just around it a little instead two coats.

I also had a major output after smearing on paste and was in the process of spreading it down..instead of taking it all off I showered and only removed what wasn't stuck well to the skin.

I flattened this layer out and blow dried well then covered with skin protectant including unpasted skin. Then another paste coat to marry to the wafer.

So we'll see how this works.

[Shamrock4806]

Ew, not long.

Apparently I put too much paste too close to the stoma, when I put the belt on it almost covered the wafer hole. It was still working as liquid was filling the bag. However we went out to Benihana for lunch and the small veggies in the fried rice got stuck behind the paste and it built up a nice bubble. Caused a leak.

So after a few hours in the shower, got a new bag with a twist.

I put stoma powder on the damaged skin around stoma and dry brushed off excess with toilet paper. Then I coated the adhesive area with two coats of skin protectant, dried well after each coat, then placed large barrier strips around the stoma away from irritated skin, then coated the crack and exposed damaged skin around stoma with another layer of skin protectant (above the two I already do on the skin) dried well. Then no sting paste a bit further out and spread down and wider, mimicking a ring in size (important), then more on the left and right sides where belly fold is, then the horizontally weakened wafer and pressed down gently but not to squeeze paste out or over the wafer hole again.

I watched that the paste did not squeeze out much beyond the edge of the hole in the wafer (I use clear bags to see). I pressed down around the stoma gently to get the paste to touch skin to bind. I waited an hour laying down with gentle pressure to ensure the wafer didn't pop off or something, until the paste set up quite a bit, then I applied my belt with just gentle pressure.

I put a pillow under my right cheek to keep the wafer about level and also a left pillow to keep me from rolling on my left side, basically keeping me sleeping totally on my back. I think sleeping on my right side was causing the granuloma issue and sleeping on my left side causes blowouts. I think it's the belt that's responsible as rolling and shifting is using the belt to pull on the wafer.

So this new process is entirely new, normally I would put the paste down then the barrier strip over it to press it down then more paste then the wafer.

The olive oil based skin lotion is working well on my scar tissue. I've been lightly coating the scar just before placing thin cardboard over it then the exterior adhesive strips to hold it and the wafer down.

I must solve this issue because the output burning the skin just below the stoma has caused a small trench to appear, I need to have this skin healed up.

This bag of mine has been the greatest challenge I've ever faced in my life. Its completely consumed me and a lot of my financial resources and it's been over a year of trials and tribulations. However I'm determined to find out what works well for me, that I can go 5-7 or even more days with hardly any problems. That there will be no pain, no irritation, no leaks and no smells. That I can drive, work and exist again just like any other person, instead of laying around watching Netflix all day.