Mixing a barrier ring with paste

[Shamrock4806]

So I've been having this problem where the inside of the convex wafer bag was rubbing on the top of my stoma causing a slight irritation and a graneoulma was forming. I had a graneoulma on my peristomal skin next to the stoma and made it go away by adding more paste and a piece of cut out from the wafer hole to avoid the wafer hitting it, so I said to myself 'well why not combine the two?"

So I dug into my old supplies and found a box of thick rings, stretched one out and placed it on the back of the wafer about 1/4" away from the cut wafer hole and up to the 2" edge of my convex bubble. Then squirted my normal three bead rings of paste around the stoma like I normally do and sandwiched the whole mess together.

Sure enough it worked marvelously, now neither graneoulma are being irritated and hopefully as a bonus the gap between the stoma and the ring will act as a holder to keep the thick paste from running which it does do that in our high 80° F heat. I use extra large barrier strips around the wafer adhesive to better hold the entire mess in place.

Note that I do have a half flush stoma in a belly fold which has been most difficult to address but as time progresses I am getting better at being more problem solving creative about these various little issues. Paste has its attributes as being a great unevenness filler and not irritating granuloma's unlike something more solid will, but too thick paste has its own problems, like running.

So anyway I thought I'd share this little tip to let lurkers know that combining a ring and paste does work if they find themselves needing a bit more height.

[Shamrock4806]

Okay going all the way around the stoma with the ring didn't work out as well as expected.

Since my stoma is high on one side and both graneoulmas are on the same side, I instead cut a section of ring to put into the belly fold side of the wafer bubble edge to keep the wafer off both. Three bead rings of paste on the skin like before.

[Shamrock4806]

Didn't work, something else was wrong.

I think the skin decided to shed big time. Only got a day outta the wafer. Bummer.

[ileo73]

Back when I was having granuloma issues -- before switching from a "Tupperware" system fixed it -- hydrofera blue was a magic bullet. I needed another dressing (Brava sheets or Duoderm or such) to hold it on but it did help drive in the granuloma.

[Shamrock4806]

Okay that's cool thanks.

I've solved the issue, my wafer needs to tilt slightly down on my left side and up and off the graneoulmas on my right. So I placed two stacked 1/4 pieces of the wafer hole cut out behind the peristomal graneoulma to protect it from the wafer touching it.

I then put on two bead rings of no sting paste around the wafer hole and sealed with extra large barrier strips all around

I also added an extra barrier strip on the left side on top of the bag to hold it down on that side

A new addition is added two small 1/3 barrier strip pieces to either top side of the bag to transfer the weight of the bottom bag part when full to either side of the bag and onto the barrier strips instead of upon the center with the barrier adhesive which was always causing leaks and runs at the top and bottom.

I think I've solved a major design flaw, the barrier adhesive can't take any strain what so ever and the Coloplast Sensura wafer adhesive doesn't have enough surface coverage, why I have to use extra large barrier strips.

I've learned that the barrier adhesive can't be moved around at all, nor take on any strain. For it to work well it needs not move or wiggle or anything at all, just so its job of sealing and that's it.

My previous problems with leaks have been because the wafer was moving around, but since I've started to make it stationary it's been working a lot better.

[GeorgeS]

I assume all the fuss over granulomas is pain? I have had them for a few years as well and initially brought it to my ostomy nurses attention. He said it was normal but didn't really say what the name was or the cause. Fortunately mine do not hurt or cause any problems.

[Shamrock4806]

Yes mine hurt a little, it's annoying.

I've learned to either cushion with paste and keep anything hard from touching them and they behave.

Just have to stop touching as that puts downward pressure.