UOAA Discussion Board

Okay bag was aching and I didn't know if it was being caused by a leak or just the paste hardening up. So I just went ahead and changed it.

Seemed the wounds have healed some and that's a good sign. So I repeated this newer process again.

It sounds kind of dumb to be putting barrier strips around the stoma under the wafer, but when a failure occurs between the paste and the wafer, the skin is protected from the blowout while the external barrier strips hold the mess from escaping. Sort of like a pocket of sorts. This may sound wasteful but if away from home and a blowout occurs, at least I'm not suffering in pain much or get spew all over the car and myself.

I think I'm going to try going without the belt for awhile. At least until the paste has really firmed up.

I waited a few hours and the paste did set up better, the object is not to get the paste to squish out under the pressure of the belt. Rather to have it form a wall of sorts around the stoma and protecting the granuloma. It seems to be working. I'm not needing the pillow under my right cheek as much anymore. However I do keep pillows on both sides to prevent rolling onto my sides while sleeping.

I also switched to using a few drops of antibacterial dish soap and just plain water in the bag to wash and flush. It leaves a little soapy residue to mix with output. The antacid water was leaving bag residue. I might just use the antacid water on the road instead.

I'm very happy with this new process.

Definitely working out better, having the belt off has been fine, less granuloma irritation.

The key is using lots of paste covering the flat part of the wafer and double on skin, then marrying and allowing a few hours on my back to let the paste set up.

Combined with extra large barrier strips all around, holds everything in place without the need for a belt.

I have a near flush stoma, so there is some above the skin surface. Just not enough unfortunately.

There are aches here and there, granuloma irritation, but it's less than with using the belt. I might be drying out the skin too much using the antibacterial dish soap instead of moisturizer soap, so I'll change up on that. Use the dish soap only once to sanitize next time around. See if that cures the issue.

Bag change, seems I developed a small leak on my right side, likely from getting off bed on that side.

It itched but didn't burn so I didn't know what to make of it, so I went ahead and changed it out.

Seems a belt would help, but then it aggravates the granuloma. So since the granuloma is the worst pain right now, that's what I'm going to cater to.

The three coats of skin protectant is surely buying me more time. Burns got worse this time around and of course a new one on the right side where the leak was. I think I didn't press down the paste around the stoma very well last time..it ached but i thought it was the paste setting up, grabbing the skin.

It's hard to tell which is which, at least the coffee caused burns were severe and I knew there was a leak. But I'll take less pain anyway because I'm a wimp..

Okay just a recap of my newest procedure

1: Remove excess paste etc by sideways scraping using a wooden coffee stir stick. Wash area using antibacterial dish soap once, then rubbing in conditioner, then washing only after that using bath soap.

2: Dry area very well. Apply stoma powder around stoma, blow dryer and toilet paper dry brushed any excess off until near invisible or nothing more would come off.

3: Applied two coats of skin protectant (I use generic Flonaze) dried very well after each coat.

4: Place 50/50 cut extra large moon barrier strips about 1/2 inch away from stoma and heat activate with blow dryer. Ensure area around stoma is dry. Apply another coat of skin protectant around stoma and crack if adhesive barrier strips. Dry extremely well.

5: Lightly coat scar tissue with olive (or coconut) oil based skin lotion and cover with cut thin cardboard strips, fill belly button with toilet paper and cover with cardboard square. If possible use the barrier strips around stoma to hold cardboard in place.

6: Horizontally weaken wafer (hole previous cut to size of stoma) and remove backing. Place a tube of no sting paste around stoma and using coffee stir stick, press towards and down around stoma to adhere to skin. If skin was sufficiently dried it should work no problem. Place another ring tube of paste around the first one. Then cover the flat wafer area with yet another tube ring of paste. Usually uses a half a tube.

7: Line up upper and lower rings of paste, wafer hole with stoma and apply, gently pressing down just enough so wafer flanges will barely contact skin. The paste should appear only around the edges of the wafer hole. Not covering the stoma, this is tricky. Also pressing down around stoma to marry paste to skin without it squirting out further. Lightly press wafer flange onto skin all around, just the edge. This is creating a wall of paste around stoma and gives maximum paste adhesion as I'm no longer using a belt because it's been aggravating the graneoluma.

8: Hold into place and let the paste set up awhile. Then apply extra barrier strips all around to hold the whole mess into place. Wait laying on back for a few hours to ensure paste has set up. Blow dry activate barrier strips.

9: Address fistula stoma by cleaning and covering with low stick tape and petroleum jelly.

10: I'm sleeping with one pillow under right butt cheek to reduce pressure on graneoluma and a left pillow under left arm to prevent me rolling off my back and onto my sides which causes the wafer to peal off and leak. Because the convex wafer is floating more on the wall of paste, the wafer flanges not all the way pressed down onto the skin, there is a pocket of sorts, using the exterior barrier strips, to contain output in case of a major leak. The barrier strips around the stoma protect the skin from surface output attacks. Where it might be awhile before I'm home or awake to address.

11: What I'm still having problems with is graneoluma swelling on its own, likely through movement as it doesn't hurt at night even if producing output, just in the daytime for some reason. I've also noticed that sitting in chairs and on couches causes wafer strain and leaks. Whereas sitting on stools or toilet does not. Likely because on stools my legs are straddled on either side and I get up using legs. Whereas in a chair one has to bend at the belly more.

Okay two days and another bag change.

What I was doing was cutting a bigger wafer hole on the right side to accommodate the graneoluma as not to irritate it. Well that had the unfortunate effect of not marrying the paste well onto the skin, so it was leaking a bit and damaging skin.

So I really went bananas this time.

1: Stoma powder, three coats of skin protectant dried well. Scar tissue and belly button covered with olive oil based skin lotion and thin cardboard pieces.

2: A thin protective layer of no sting paste out to 1/2" from stoma.

3: 50/50 cut moon shaped barrier strips on top pressing the paste down well onto the skin all around and next to stoma. Also holding the cardboard in place. This is the method that yielded me 7-9 day bag wear times before. So I've adopted it again.

4: Two ring layers of no sting paste around stoma on top of barrier strips creating a wall.

5: Marry a smaller cut hole, horizontally weakened wafer on top and pressed down just enough for the wafer flanges to stick to surface. Barrier strips all around. No belt.

Let's see how this goes.

Four days and a new bag, getting better.

Graneoluma side burn healed up, little one on the top the same, bottom one the same, twice the size of the small one.

I can only figure because of both top and bottom that it's a shear issue caused by bending at the belly.

Been sleeping with pillow under right butt check and slightly elevated upper body to level bag and get the contents to drain towards the bottom away from stoma. So biggest burn is at the bottom.

I clearly need some sort of better adhesion product to protect the skin around the stoma and remain flexible.

It's the only problem I have now really, the graneoluma is almost disappeared and almost no pain now.

Same procedure as previous.

What I'm thinking is some sort of liquid product that after pouring on top of the barrier strips next to the stoma, would fill micro gaps and solidify so liquid output won't easily work it's way to the skin surface.

Paste doesn't flow very easily and I think this is where I'll focus my attention next.

Unbelievable....

Blowout about a few hours later.

What happened was mr. stoma decided to output some past harder undigested stuff from a few days past because I didn't eat much today and it was stuff I know liquidifies upon exit. Chicken breast, bread, French fries for lunch and a couple of pancakes this morning. This pancaking occurred right after consuming chocolate milk and a microwave pizza for dinner, the output was dark and thick, likely pushed the old solid chunks still stuck in the system with it.

So it caused a pancaking issue and popped the not completely cured wafer right off. Went right under the bottom of the stoma paste, under the barrier strips, hit skin and was stopped by the external barrier strips where it leaked just a little bit enough to let me know.

Good thing the barrier sheets all around held nearly most of it. But I rinsed the debris to see the large amount of old chunky stuff causing the problem. Stuff I ate days ago.

What bad timing.

I'm just not having any good luck at all.

I did change up slightly by putting another layer of cut barrier strips around the stoma on top of the first one and slightly more paste (not such a thin layer) under the stoma barrier strips. Made an extra effort to press down to get a good skin bond.

I also put the belt back on as I'm not feeling any pain from the graneoluma, but it's on light and after the paste hardened up quite a bit.

Still doing the whole sleeping only on my back with a pillow to level the bag thing. I don't know if it was because of the night draining on that side that caused the graneoluma or was the belt/wafer irritation. I do recall the wafer being bent out of shape to fit, so now with paste hardening up first, hopefully provide even pressure around the stoma instead of off to the edges.

Wish me luck.

I don't know who I pissed off but they sure had it in for me today. Really I can only blame myself.

Anyway I woke up with a good bag on, so I had to take a 5 hour round trip and stupid me ate my favorite poke with.... edamame for lunch. Smacks head.

Well sure enough a few hours later the pancaking begins and I feel the slight pain of a leak. Get home and redo the whole mess, but put too much paste over the stoma and it backed up again. As I ate the edamame in two separate sittings.

So this time I'm just tired of all my extensive attempts at getting back to a 5-7 day bag and just did a quick slap, just paste, the wafer and barrier strips all around, will put the belt on next when the paste sets up good.

I'm just tired, it's been a hectic day and two showers and two bag changes, plus all that driving..

I've adjusted the car seat so I'm more straight and bending ar the waist, didn't really help any.

I don't think it's possible for me to get a long life out a bag anymore. May have to resign myself to a near daily change.

I am going to systematically contact every ostomy maker and request samples from all of them to see what my future options are. Because what I have is not working. Sometimes the Coloplast convex are stiff and sometimes they are not, but rather flexible.

Next morning, quick slap is working, I think a lot of my overdone methods were because of earlier coffee use which made the output burn far worse. And the stoma belt being on too tight, me laying on my right side which pulled the belt harder.

I need to get this issue resolved before the holidays arrive.

I should note I'm using one of the softer flexible sensuro mio convex wafers, don't know why I have a mix of both stiff and soft. I just had shipped a new supply, will be checking each box and with my supplier.