Ostomy questions

[ot dave]

EDS,

You are basically describing a two piece pouching system. I use the Hollister New Image line 2 piece appliance system. The only thing is that the flange is an adhesive. I place the flange on, usually once a week on Wednesday nights. I come home from church, remove the flange, take a shower, and lay on my bed for 30-60 minutes while watching tv. My skin really doesn't need any more rest than that, and I can inspect the skin at that time for potential problems. This system allows me to place an irrigation sleeve in the morning to irrigate (which usually gets me 24 hours of no output). After I shower in the morning, I place a drainable pouch onto the flange and go about my day. The drainable pouch allows me to empty the pouch should I need to during the day...anywhere. I usually have access to a water bottle that I will fill with warm water and rinse out the pouch when I do need to empty. The warm water clears out the pouch making it feel like a new pouch every time. It removes any output that might be touching my skin, which reduces irritation to the skin. At night, before bed, I place on a closed mini-pouch to sleep in, because like you, I didn't like the tail of the longer pouch getting twisted in the sheets at night. You can easily remove pouches without affecting the skin with a two piece system. If your skin is sensitive to adhesive, you might want to try using a spray on skin barrier. Cavilon is a popular one. I use it when I have a place under the flange that looks like it might become an issue while the flange is in place. Otherwsie, I only place a flange on my skin. I only remove the adhesive flange once a week, so no skin irritation because of placing and removing pouches every day. I will state, that the more output that gets onto the flange, the shorter wear time I will get.

The non-adhesive flanges with a belt that you are referencing, are kind of a last resort for most...that's just my perspective. You have to pull the belt so tight to keep the flange from leaking, that it would be too uncomfortable to wear for any length of time. Also, with the movement of the torso throughout the course of the day, you can almost guarantee a leak of some sort, just because of the changing contours of a moving torso. With adhesive flanges, this is almost eliminated. I would only use a belt/flange set up if I were laying still at home with no intentions of getting out of the chair, and I definitely wouldn't leave the house in one!

I hope that helped some.

David

[EDS]

Thanks for the input David.

I concur w your thoughts on the potential cons of wearing the belt type non adhesive system, such as having to wear the belt so tight, and seemingly inevitable leakage.

I think that part of my frustration is that I am a new ostomy patient of only two months, and the pouch system is incredibly uncomfortable to me.
And thinking of going the rest of my life w this type appliance is kind of a depressing disconnect for me.
Maybe I'm still really sensitive and a bit sore from the whole abdominal area trauma of surgery. But I know really the flange and adhesive are my issue. I am uncomfortable from the time it goes on, until the time I take it off.
One thing I know for sure, is that the bags are too long and obtrusive, no question, and get in the way and by virtue of the length pull upon the flange, and thus my skin. Possibly for me the answer might be to cycle and rotate between a belt type non adhesive system, and the adhesive and flange type system w a switch to the small mini pouches. I think I would much rather empty the small pouch more often if needed, than wearing the aggrivating and incredibly annoying long Hollister pouches.
It so just seems like there could be a vastly better and improved system design that is conceiveable. One at least not much larger than the stomas themselves. I do not like that the hard plastic flange w the three little protruding pieces, and the bandaid like outer material are like four times the size of the stoma.
That may be one of my biggest issues, the size of the whole appliance itself.
Seems like there could be a design that adhesive flange and pouch could be much less smaller and unobtrusive. Seems ridiculous to have a pouch that hangs down 8-10 inches or however long it is. Also seems like the wafer itself could be not much larger than a fifty cent piece. The bandaid material is virtually useless and comes unstuck usually within the hour, so why does it need to be so large, or there at all, something like its four or so inch square? It comes loose and the only real thing holding the appliance on is the paste ring directly surrounding the stoma.
I have not ordered product yet from my initial hospital supply given me, but may switch to the round mini pouches on my first order and see if that lessens some of my frustration. I know that I will have to figure something out, as I have no intention of wearing these long hanging and pulling bags the rest of my life.

Thanks for your reply and telling me what you do as hearing from others is helpful as I am new to this and still figuring it out.

EDS

[steiconi]

EDS, call the manufacturers, talk to their staff (often an ostomy nurse) and get free samples. You'll probably be able to find something more comfortable.

here's some contact info to get you started:

B. Braun Medical (800) 227-2862

Coloplast (800) 533-0464 1-877-858-2656
(888) 726-7872 http://www.coloplast.us/about-us/colopl ... lsrc=aw.ds
http://www.us.coloplast.com/Pages/home.aspx

ConvaTec 1-800-422-8811
staffed by WOCNs http://convatec.com
http://www.convatec.com/en/cvtus-produc ... ducts.html

Cymed, Inc. (800) 582-0707

Dansac (800) 699-4232 http://www.dansac.com/

Genairex (877) 726-4400 http://www.genairex.com security

Hollister (888) 740-8999 http://www.hollister.com/

Marlen Ostomy Care Products (216) 292-7060 http://www.marlenmfg.com/

Nu-Hope (800) 899-5017 www.nu-hope.com (form on line) Hernia belts, Non-adhesive systems

Ostomy SuperSan (888) 888-3095 New company making pouch

The Perma-Type Company (800) 243-4234

[EDS]

Thanks Lee.

The list of companies including their contact info is and will be quite helpful.
I will do just that, contact them and request some free samples.
I just know that the supply given me initially, the Hollister 18183 pouches, work and do the basic job, but are far from being the most intelligent design, and could easily be improved upon. Just like the pouch is a full two inches ABOVE the stoma. What a useless design flaw, as there is no reason whatsoever that I can discern for being above it where it is a gravity system for the most part, w the matter falling southward. Not to mention width, why does the pouch at the height or level of the stoma and above it go five inches across? I get that they were making room for bag expansion, but being that the bag is not supposed to be let get more than 1/3 full.
Minimal was not in the design mindset for this particular model.
I'm sure that perhaps some of these other companies have some designs more appealing and less obtrusive, w minimal in mind.

Again, thanks.
EDS

[EDS]

Just sayin', another design flaw in the reuseable model I have, is at the bottom of the bag, the three or so fold up emptying bag engineering. Where emptying and opening the bag to clean it, again works, but is just not intelligently designed.
Easily a better design would be to emulate the efficient smart design of a tube of toothpaste.
A screw on cap, take off, squeeze out waste, reapply cap, done. No mess, efficient.
Thats all I'm looking for, a design where some noggin power was involved hopefully by someone that actually wears the appliances.

One can google ostomy pouches and among the
The many images that pull up, few if any look like anyone has really put any thought in reengineering the appliance.
Just seems to me like there ought to be any number of different designs like in my short time as an ostomy patient that I've thought of myself.
But, they all look the same, like from the same playbook. Nothing different, all basically the same.
Maybe its just me, not settling in yet as to the limited options that I see. Anyway I'll search and request samples from the different companies to see if I can find something that becomes but a second thought in everyday wear. Or if not, design my own.

EDS

[steiconi]

The pouches seem ridiculously big until you get a lot of gas or can't find a restroom. Then you'll be glad of the extra space. And when you're lying down, gravity goes everywhere!

I really dislike Hollister's flange system that sticks out real far. It's nice when you're sore from surgery and don't have to put pressure on your belly, but after the first couple months I didn't need that.

[EDS]

Good point(s) Lee.
I suppose if one had very runny loose stool, lying prone the gravity change would let the matter run into the top area. But if there weren't that xtra area in the first place, it wouldn't go up there and stay down in the area where it is supposed too.
Honestly, your point on xtra area for gas is a good one. When not in public, I crack open the flange/bag attachment and flatten out the bag releasing the gas. Is a good legitimate point though for when in public.
I was initially told by the ostomy wound nurse when still in hospital, that the bags were designed to let the excess air escape thru the little charcoal or whathaveyou filter slowly.
I've not really seen that happen though so far, as the air seems to stay in the bag.

I concur as well w your statement as to not liking how far out the bag protrudes. That, along w the area as large as my fist w the stoma makes my belly really stick out a good bit. I'm hoping some of that is post op swelling that will eventually go down somewhat. I wear one of those back support type belts when in public and at work to conceal and to muffle sound as well, adding to the belly circumference.
Its a good thing I'm not fat, and before surgery had a size 34-36 waist, or I'd really have a large belly possibly making me get some larger roomier shirts.

EDS

[steiconi]

filters don't usually work all that well for me; I've had some leak and some fall off completely. I get non-filtered bags and burp as needed.
I was thinking nighttime gas needs the bigger bag. Had some lovely garlic chicken one night, wore a tiny bag to bed, and it blew out my wafer. I wear big bags at night now.

[ot dave]

EDS,

You might want to investigate the cymed product line. They are very low profile, and their pouches, though sufficient in size, are easily camouflaged under your clothes. No hard plastic rings. To me, they weren't as user friendly when it came to irrigating and using a different pouch to sleep in. I think they had an adhesive 2 piece system, but I didn't feel that it was "strong" enough for my needs.
As far as dealing with the length of the pouches, I simply tuck them in my waist band, pulling out enough for the pouch to be able to fill, but still stay tucked in to the waistband. I wear compression shirts too, which helps keep them close to the body, camouflage them, and allow for output to go into the pouch without too much resistance, thus keeping the flanges from leaking. I'd be concerned if the flanges got too small. The size allows for some "breaching" to occur and not create an appliance failure, until you make your next flange change.
Also, if you don't want to tuck it into your waistband, there is a product called Stealthbelt, you can do a search on them as they are mentioned here frequently. The stealth belt covers your flange and has a pocket to keep the tail of your pouch collected and out of the way. The design is meant to wear the pouch sideways, which I didn't like because it made it too awkward to change efficiently. When I use it, I simply place my pouch on correctly, but roll the tail up and zip in into the pouch. The belt is made of a spandex material, so it expands easily when the pouch fills up.

Tail closures are something you kind of have to learn by fire! A screw on cap system that you described, would not be preferable for me. It would be too big to fit comfortably under my clothing, especially since I tuck the tail into my waistband. Additionally, my output contains a lot of output that would either be too thick or too big to exit. That said, I could spend more time chewing my food and making sure that it was smaller, but chewing asparagus or mushrooms that long is not appealing to me! And, corn, now matter how long you chew it, would still bunch up and get stuck in small area! When emptying, I have toilet tissue handy, making sure to have enough to fold over both sides of the tail to wipe off anything on the outside. Then, I squeeze the tail so that it pops open, toll the toilet tissue up to resemble a tampon, place it inside the tail deep enough to still be able to grip it, let go of the opening, and use the tissue to wipe out the inside of the tail., then remove the tissue. This really helps to keep the closure clean. I also use warm water to rinse out the pouch each time I do empty. Helps to make the cleaning of the tail easier, with other benefits as well.

Hope some of that helps.

David

[BillGK]

I used adhesive coupling products. There is no bulk whatsoever, like there is with the plastic snap ring products. I use a Convatec wafer that has a dock for an adhesive-attached bag. I don't use the complementary Convatec bag, because I prefer the Coloplast adhesive-coupled bags. These are closed, disposable no-messy-hands bags. The Convatec wafer is more flexible and comfortable than the Coloplast wafer.

So I have a mix-and-match solution. It works great, is exceptionally secure (accident avoidance is key for me), discrete and comfortable, and no messy hands.

[steiconi]

EDS, been thinking about the pouch design.
The extra space at the top of the pouch looks like a manufacturing necessity. They apply the tupperware ring to one piece of plastic, then fuse that to another layer. The machine has to go wide around the tupper.
Lee

[BillGK]

I have no inside information, but when I look at my bags I see advantages to having the extra material above the stoma.

I am using the Coloplast Sensura 10914 bag. As a result of the extra bag material above the stoma, the stoma doesn’t get squeezed when the bag starts to fill, as follows: When the bag is empty the part of the bag above the stoma is in a vertical position, and the inside and outside of the bag are basically touching each other, and the outside of the bag is laying lightly against the stoma. When weight is added to the bag, the top of the bag rolls forward, into a horizontal position. Due to the slight rigidity of this part of the bag, rolling over creates a geometry that provides about an inch of clearance between the inside and outside of the bag, creating a space for the stoma so that it doesn’t get squeezed by the weight of the output acting on the bag. If there was nothing above the stoma, there would be a wedge formed right against the stoma, and weight in the bag would squeeze the stoma, no doubt creating rubbing and pressure, not good. This feature is no accident; it had to have been designed with this in mind. And it is a feature that was designed into the product at virtually no extra cost, and it is a feature that is so simple that there is nothing to fail or malfunction, really.

Another important feature of this extra material, for me, is that when the top of the bag leans over the filter becomes the highest point in the bag. This positioning gives the best chance for the filter to not get clogged by output.

I am generally impressed with what I see. Especially Coloplast bags. We have to understand that ostomy supplies are a relatively low volume product, and the field isn’t necessary one that is populated by rocket engineers who graduated magnum cum laude and are going to send astronauts to Mars. I have used literally thousands of these Coloplast bags, and had only one bag failure. In my view this is an impressive track record for a product that costs a little over a buck.

[Button]

EDS:
I have been away from the forum for ages and only recently figured out how to reactivate my account . . . and your thread caught my eye.

I am petite, 5' 2" tall and 85 pounds. More child-sized then adult-sized. Finding a pouching system that was optimal for me was not that difficult. It required acquiring samples from different ostomy manufacturers and a bit of trial and error.

First, most ostomy manufacturers provided different sized pouches. There are different acronyms, similar to StarBucks' use of different names for graduated drink sizes (grande, vente). Coloplast, for example, has three different pouch sizes for its product lines: Mini (5-6 inch pouch); Moda (8-9 inch pouch); and Maxi (12 inch pouch).

I use the Coloplast Mio, Mini pouch and love it. The Coloplast Mio has a unique wafer polymer that employs elastic fibers within a hydrocolloid matrix. The result is a thin, pliable, flexible wafer that adheres intimately with the skin and moves as the body moves. It is like wearing no wafer.

I also use the CyMed MicroSkin line. CyMed MicroSkin is similar to TegaDerma or DuoDerm, a thin adaptic material that looks like Saran Wrap kitchen food wrap. MicroSkin is like a second skin, closely contouring to the topography of the skin. CyMed offers a 5" mini pouch as well as a mid-range 8" pouch and a larger 12-14" pouch. CyMed offers both one-piece and two-piece ostomy systems. The CyMed system is unique.

Hollister offers a 6" mini pouch as both a one-piece and two-piece option. The Hollister Mini pouch was the first ostomy system that I used after surgery.

Each of the ostomy manufacturers also offer "pediatric" ostomy systems. You do not need to be a child to use a "pediatric" pouching system. I have also used Coloplast and Hollister pediatric systems, preferring the smaller wafer base plate size and 5-6 inch pouches.

There are options out there. I have been singularly impressed by the quality of the ostomy pouching systems that I have used from each of the major manufacturers - Hollister, Coloplast, ConvaTech, and CyMed. I selected Coloplast and CyMed as my "go to" ostomy pouching systems because their wafers were more friendly to my skin. Keep searching, keep requesting samples from each of the major manufacturers until you find a pouching system that is best for you.
- Karen -

[danilynn]

EDS:
I have been away from the forum for ages and only recently figured out how to reactivate my account . . . and your thread caught my eye....
- Karen -

Button - good to see you posting! I was hoping that you were all right.

[EDS]

Hi Danica, David, Karen, Lee.

Thanks for the input and feedback.
Has been a week or so since posting last as my last post was on an iphone and lost my post before it went thru as, for inadvertantly hitting incorrect button, and poof, it was gone.
Then I was trying to catch up from not working for the better part of two months.

Anyway, I think these chat type rooms are good to converse amongst ourselves on any issues.
All of you have given some good substance for me to figure out how I want to go for the most comfortable quality of life for living w this new life issue.

I have since, after thinking about it, and considering your remarks, gotten an understanding of why they make the bag above the pouch. For one, giving the room to expand to give the stoma output room enough to fall easily towards the bottom of bag.

I am as we speak awaiting product samples from the different companies to try, along w your suggestions of what you all use.

I'll keep you informed of what I find.
But, I have to say that one of my issues is the process of draining the bag is incredibly annoying to me for reasons I stated before.

I sometimes wait until the bag is really full enough to pull on the wafer before emtying as for its time consuming and messy process.
I still believe in my previously stated post describing a toothpaste cap type emptying system. I tuck the bag into my waist as well, and a TP cap would not be thick enough to be a hindrance or unduly uncomfortable.
As for corn, or mushrooms, etc being hard to expell from that type system, I do not believe that would be a problem at all. A little bit of pressure when expelling would force out any texturzed food product.
The main point being, that emptying bags would then now be, a non issue and simplistic, mess free and be done in mere seconds as opposed to minutes.
I think there are very few, if any post digestive foods that could not be easily forced out of a toothpaste cap system.

EDS