Okay had some bleeding today

[Shamrock4806]

I don't know what I did wrong, but after one day my seal failed and I was feeling a little burn, sure enough removing it the leak wound was bleeding.

Also there was a thick amount of what I think was skin protectant that wouldn't let go and I had to scrape it off the skin to get to real fresh flesh. I don't know maybe it was my skin shedding or something. It likely doesn't have a chance to do that much under the wafer nearly all the time.

I used a piece of a barrier ring to keep my wafer off my two graneoulmas and it was stuck onto the skin very well that I had to scrape it off with a plastic knife.

So I did the whole stoma powder, brushed it dry and coated the wounds with just one spray of skin protectant and used the entire ring around the stoma this time. I haven't used a ring in ages.

I've been suffering with paste running and oozing around due to heat and movement, wasn't impressed with the holding power of rings in the past, but maybe because my skin wasn't prepared properly like I know how to do well now.

I also have had some itching on my chest scar covered by the extra large barrier strips, so when I shower with the bag off I first rub some lotion into the scar and wait awhile then use a little soap and a washcloth to wash it off, thus moisturizing the skin below the surface and clearing the top for adhesion. This has seemed to reduce the itching quite a bit.

So we see how it goes.

[Shamrock4806]

Ring only seems to be doing very well, it has run a bit from the top down so it's not perfect.

I think my body shape has changed and paste might not be cutting it anymore. If the holding power of the ring is much better it might be the way to go for me. I'll know when I do a bag change.

[Shamrock4806]

Uh, lasted not even two days.

I have a graneoulma on my peristomal skin next to the stoma and it seems when my belly swells like I have food in the system it tightens the wafer down and the wafer pressure aggravates it.

I put the ring all the way around and on top of the graneoulma not knowing what it would do. When I peeled it off the ring came off much to easily which is a warning sign that adhesive is not anchoring well enough to the skin.

So I'm back on putting a couple of pieces of the wafer cut out just outside the graneoulma to stop the wafer from touching it and using paste like before.

My problem is adhesion is weak near my belly button area where I try to protect scar tissue inside the belly button hole that the extra large barrier strips grips onto. So I've put a thin piece of cardboard over it.

Before I was using a belt but the belt was pulling on the right side and caused the graneoulma in the first place so I don't use the belt anymore.

Three thick rings of paste was working to hold it but it would tighten up after two days and hurt. So this time I used two rings of paste and then the extra large barrier strips all around.

Then an extra one on top of the left side of the bag itself to hold it down better.

I should have thought about doing this earlier.

[Shamrock4806]

Okay finally figured things out, again.

My belly is sort of indented in the middle where the belly button and scar is, so the wafer needs to sit at an angle, lower at the belly button side and higher on the right side where the graneoulmas are.

The belt was putting pressure mostly on the right side causing the graneoulmas to form.

So now I'll keep the wafer elevated on the right and down on the left.

[Shamrock4806]

Absolutely a BIG difference, oh my god!

I feel almost normal again. Definitely has uplifted my spirits and make me feel more confident.

So on the right side of the 2" wafer hole I place two stacked pieces of cut out just slightly back from the peristomal graneoulma. Squeeze two beads of paste around to cover the 2" wide convex bubble and after the wafer is on and secured with extra large barrier strips (and a piece of thin cardboard over the belly button scar) I then placed one more extra large barrier strip over the bag itself centered on the belly button and matching the circular shape of the first barrier strips. Note I do use a one piece, so this wouldn't work with a two piece if one needs to remove it.

Excellent!

[Shamrock4806]

If anyone is interested I have just updated my entire procedure here. It likely WILL NOT be completely appropriate for your condition or body contour type or stoma shape for that matter but it can help in other ways by learning how another does their appliance application to ensure a good adhesion.

24 months post surgery and still learning new tricks!



Wait until stoma has quieted down by watching bag contents until it slows down filling up. Small nutritious non diarrhea causing meals over the course of the day with more food during the morning and early afternoon on a good bag and less during the later hours or if a bag change is going to be needed soon so the system clears out. Hunger causes bile to be produced so not feeling hungry on a empty system equates to a quiet stoma. Less food at night also reduces bathroom visits and accidents.

Products used:

Brand: Coloplast
Bag type: Sensura Mio 2" wide convex drain able one piece.
Brava No-Sting paste, spray adhesive remover, spray skin protectant, stoma powder and extra large barrier strips

Prep.

With the blue side up, roll the end of the wafer bag and lock with Velcro. Then cut a larger oval hole in wafer through small hole to 30 vertically, then across to the left side line between 30 and 40 (35). Then around to 30 line again and then to the 35 line again and then complete the oval.

Slightly bend the wafer bubble a little so it's flexible. Remove the backing. Apply two 1/3 pieces of the wafer cutouts stacked, behind the peristomal graneoulma sticky side out. Place single stacked u-shaped thinner width cutout pieces around the circumference of the convex bubble to act as a paste slide resistor. Set aside.

Removal:

Remove old wafer by using spray adhesive remover along the top and spraying the crack as i peal down..plastic bag and seal for trash disposal.

Remove covering over mucus fistula and clean hole with coffee stir stick if needed.

Use a flat plastic knife to remove thick paste and wipe off using toilet paper. Clean with toilet paper and a bit of water. Used toilet paper into the toilet.

Use adhesive remover to try to remove more adhesive.


Shower:

Rub skin lotion into chest scar only and allow it to soak in. Do not get lotion around anywhere else under wafer area as it will loosen adhesion.

Wash the area with nothing but water and a washcloth to remove more residue paste. Also more adhesive remover to remove an invisible film for clean bare skin. Wash entire area with water to remove adhesive remover. A tiny bit of soap on the scar tissue area only to remove surface slick.

The skin around the stoma needs to be clean, fresh and clear of anything for adhesion to work properly. Dry skin around the stoma can use the lotion then soap trick until skin is normal and healthy again.


Preparation station on bed:

Dry very well using blow dryer and dabbing with soft dry toilet paper. Have a towel underneath in case of a sudden unexpected large eruption.

If any output gets on the skin, repeat washing and drying until it stops or just keep rinsing into toilet or use shower if a lot. Small amounts on skin can be wiped up with toilet paper and plain water used to wipe off digestive enzymes away, do not use spit, it contains salts and will burn. Not wiping the enzymes away with water will cause a leak burn later as it eats into the skin and trapped under the adhesive. Dry well again. Drying is extremely important at this stage.

Once very dry determine if there are any leaks wounds that are not drying and feel wet to the touch. These get one grain high stoma powder. Remove stoma powder with damp toilet paper from healthy skin. Dry well. Maid sure nothing comes off damp areas like clumped stoma powder. Finger test the wounds are very dry. Extremely important at this stage. A slight wet will cause the adhesive not to bond and will leak later which everything is wasted.

Note: If any areas are experiencing fungal infections then rub in anti fungal powder (in lieu of stoma powder) and dust dry, then coat area with skin protectant.

Spay the entire adhesive area under the wafer with one light coat of skin protectant..this will also lock down the stoma powder if applied. Wait 30 seconds to dry. Optional if no stoma or fungal powder used. Paste will stick to plain skin also.

Ensure skin around the stoma is very dry to the touch. Squeeze out a full bead no sting paste right around the stoma and ensure it's sticking to the skin. Put another two bead rings outside that one for a total of three. If output gets on skin or the paste, remove, discard and wash area and dry all over again. Work quickly on a quiet stoma.

Line up the wafer hole to go over the stoma and gently press down. Pressing around the stoma through the wafer to get the paste to spread and stick. Ensure oozed out paste does NOT cover the stoma hole nor the entire wafer hole as seen though the bag.

Belly button gets a small piece of thin cardboard to cover the belly button scar after the wafer is applied and before that adhesive area pressed down. It will be covered by the extra large barrier strips. Test by pressing so there is no irritation. Press the wafer adhesive all around and onto the skin and hold it until it bonds.

Apply extra large barrier strips all around the wafer edge (first one center on belly button) and under the hooks, press and hold to bond. A small piece of barrier strip may be needed for the top gap.

Place ANOTHER extra large barrier strip ON TOP of the bag itself left side centered on belly button matching the barrier strip underneath. It just catch the hard part of the wafer. This keeps the wafer from wobbling. The wafer will appear to be slightly higher on the right side than the left, but actually matching the stoma and providing a stable adhesion.

Do NOT use a belt as it pulls on the right side and warps the wafer. Causes graneoulmas on top of the stoma and on the right side. Dam belt has caused me plenty of problems.

For the mucus fistula, one piece of toilet paper folded into a quarter size, water proof tape in place to hold.

Dump bag every time it's about 1/3 full. Rinse bag with water every time, use no soap. Diet control and frequent rinsing to keep bag looking cleaner longer.

Do not touch or place any pressure on the bag as that will cause the paste to squish out and the wafer will irritate the graneoulmas. Soap will irritate and cause the storms to sink causing a leak.

Feel any pain that lasts more then just temporarily the bag needs to be changed as soon as the stoma is quiet.

[Shamrock4806]

Okay this new system has been working excellently.

I repeated with a fresh bag today but noticed when the bag is full I feel stress on my barrier adhesive.

So I cut a small barrier strip into thirds and slightly pulled the bottom of the bag up and applied two of those strips, one to either side, on top of the bag to hold it up a little and transfer the weight of a full bag to either side of the bag and onto the barrier strips instead of upon the center where the barrier adhesive is. I tug on the bottom of the bag and feel no pressure on the barrier adhesive, just on the barrier strips.

So anyway I've think I've solved another problem, that barrier adhesive can't be moved or take any weight what so ever. I just needs to remain perfectly still and unmolested by even the slightest wafer movement.

We will see how it goes but I can feel the improvement already.

Stay tuned.

[Shamrock4806]

Okay not so good, only a day and a half of wear time.

Apparently the two bead rings of paste isn't enough so I'm back to three again and NOT curving the convex bubble any, going for the flat pressure around the stoma like it was designed.

I also didn't apply those two strips to hold the bag up a little, apparently it didn't help much and doesn't allow me to put much air into the bag to prevent vacuum pancaking.

Belly folds and near flush stomas are a royal pain in the arse. But I guess ones that stick out good but touch the side of the bag cause issues too, but no problem sealing those.

[Shamrock4806]

Okay day two and everything seems fine. I think I know what I have been doing wrong.

The paste or ring sort of stays more melted in our 80° F Florida heat and I've been unconsciously pressing around the stoma checking for the pain of leaks and causing the wafer to contact the graneoulmas or squeeze out the paste.

So now I've refrained from using the belt which is designed to put downward pressure around the stoma and if course from placing it touching that causes any downward pressure as well.

I have to be careful as I have a heavy blanket in case the AC is too cold and can unconsciously pull it up on top of the wafer. So now I just use a towel on my upper chest instead.

I think I should be looking at doing or using something different that doesn't run in the heat, seems a paste or even a ring runs but the rings don't adhere or fill as well as the paste does.

Coloplast says the paste should be thin, use the belt, but I've tried that, and it still runs, doesn't hold well and aggravates my graneoulmas too.

I think I need to custom make something new.

[Shamrock4806]

Okay bag lasted almost 3 days, seems not putting any pressure on it (after the initial application) and three heavy bead rings of paste do the trick.

I'm still stacking two wafer cutouts behind the peristomal graneoulma and additionally added single stack pieces of cutout around the convex bubble to act as a paste slide stopper.

Seems to be the right formula for me anyways.

I'm basically using a paste tube to channel output into the bag. The paste remains flexible so it moves s little if need be. But learned a stationary wafer is best why I placed an extra barrier strip on top of the bag on the left side to hold it down.

Clearly the intended design with the convex to push the skin flat using a belt isn't the way to go for me because it squeezes the paste (or ring) out and then the wafer is digging into the skin.

With the belt the wafer even warps backwards like it's trying to wrap up my body this losing its flatness.

Clearly another solution is required, something that molds perfectly to my body then channels output into a bag that way. A tube sheet of plastic for instance.

Updated my process post above to reflect the newer changes.

1: Only water to rinse bag.
2: Placing cutout wafer hole stoppers to help prevent paste or ring melting and running down exposing skin to output.
3: Not putting any downward pressure or even touching the bag feeling for leaks. Bad habit.

[Shamrock4806]

Yep, frigging nailed it. Finally.

Bag is on rock solid, I feel it could last a week if it wouldn't get all nasty.

I might be graduating to a two piece, if I can keep this process up.

Nope: The slightest pang of a leak occurred and sure enough along the belly button side slightly failed.

Repeated the same steps. Put another extra short bead along belly button side but I don't think it held onto anything. I"m going to try those y shaped extra large barrier strips with the adhesive appendage that covers the belly button. In the meantime I'm going to use a ring to try to adhere the wafer adhesive better there.