INHMike wrote:MissMolly wrote:“Blow outs” (I.e. failure of a wafer with dramatic leaking of liquid ileostomy fecal output) will invariably happen from time to time.
Sometimes “blow outs” just happen, a perfect storm of incidental events that contribute to a wafer (and barrier ring) losing contact with the skin. A wafer that is well-applied forms an air-tight and water-tight seal with the skin. The adhesion of a wafer to the skin comes about from a chemical reaction of the hydrocolloid matrix that forms the wafer with the body’s natural heat/temperature. A tight seal depends on the body’s heat activating the hydrocolloid matrix.
Tips to make sure that a wafer bonds completely with the skin:
a. Make sure that the paristomal skin is completely dry and taut (no skin wrinkles, no skin folds). Often lying down is the best position to apply a wafer, as the skin has a flatter surface when supine as opposed to standing upright.
b. Avoid any skin care products that have aloe, moisturizers, or oils. Avoid any soaps or body wash with oils or moisturizers. Safe soaps to use: Ivory bar soap; Neutrogenia bar soap for sensitive skin; any glycerin bar soap; Zest; Basis. Avoid using baby cleaning wipes. The use of baby cleaning wipes will adversely affect wafer adhesion and contribute to “blow outs” (as baby wipes contain moisturizers and aloe). Safe ‘N Simple beans makes a moistened wipe designed specifically to clean pariatomal skin. Safe ‘N Simple Paristomal Skin Wipes are available from any ostomy supply provider (Byram Healthcare, EdgePark, Sterling Medical Supply).
c. Pre-warming a new wafer and barrier ring can help maximize adhesion to the skin. Use of a blow-dryer on the wafer to warm the hydrocolloid material or placing the wafer in the dryer on low setting x 1 minute are both ways to pre-warm a wafer and contribute to an air-tight and water-tight seal. You can also place a warm buckwheat pack on the abdomen for a few minutes after placing a wafer. The exogenous heat adds to the body’s warmth to maximize the chemical reaction that bonds a wafer to the skin. Avoid strenuous movement for 15-30 minutes after applying a new wafer. Allow time for the skin-wafer seal to effectively set.
d. Recognize that the temporary loop ileostomy is the most challenging of ostomy types to pouch successfully. The loop ileostomy is positioned further up the segment of small intestine than an end ileostomy. The end result is loop ileostomies have a high percentage of caustic digestive enzymes that will degrade even the most protective/effective barrier ring.
Do not go more than 3-4 days between wafer changes. Some people will need to change their wafer and barrier ring every 2-3 days. Do not try to boast about long weartime. Long wear time is for individuals with a colostomy (fecal output has low/minimal digestive enzymes).
Remember that everyone’s skin has unique characteristics. Some people have oily skin. Some people have thin/frail skin. Each manufacturer has slight differences in ingredients that compose their wafers. People will like or dislike different manufacturer brands based on how their skin bonds to the hydrocolloid wafer. Some people love Hollister while other people will dislike Hollister, just as other people will like or dislike Coloplast or ConvaTec. This is why sampling a wide range of ostomy products is helpful and necessary. What you were sent home with from the hospital may not be the ideal set-up for you. Call different ostomy manufacturers and request samples of wafers, adaptic barrier rings (analogous to a gasket in a faucet) and pouches. It is worth the time and effort of trial and error to find the optimal pouching system for you.
d. Avoid the use of ostomy paste on a wafer. Ostomy paste has no adhesion qualities. Ostomy paste is meant to fill dips and divots in the skin to make a level skin surface. Ostomy paste is amplifies to grout used in the laying of ceramic tile.
e. Lying supine at night makes a wafer more vulnerable to leaks. This is because the liquid ileostomy output pools around the stoma whrn lying supine. Just as MikeNH is doing, getting up in the middle of the night to empty the pouch can be helpful to minimize potential of a leak. It can be a good safety policy to empty the pouch at least one time during the deep nighttime hours.
You want the full surface of a wafer with an adaptic barrier ring to have full contact with the skin. The wafer and barrier ring will make an impervious seal with the skin (airtight and water tight).
The most popular adaptic barrier rings are the Ekin Cohesive Adaptic Ring (by ConvaTech) and the Brava Adaptic Ring (by Coloplast). Barrier rings snug up to the stoma and give added protection to liquid fecal output undermining a wafer and causing a “blow out.” Which ring serves you best is individualistic.
Keeping a sense of humor is also invaluable. Wafer leaks will happen. It is helpful to keep a sense of humor when confronted with a leak.
Karen
I sleep with a pile of four pillows, three under my head and one under my back. I tried sleeping on a recliner and it works but it's not as comfortable as a bed. There are foam wedges that are fairly inexpensive and I was thinking of trying one of them.
NHMike wrote:..Had a dental cleaning and they said that one of my old fillings is failing. So I have an appointment this Wednesday to get it replaced. It's just a composite so it should be simple....
O Stoma Mia wrote:NHMike wrote:..Had a dental cleaning and they said that one of my old fillings is failing. So I have an appointment this Wednesday to get it replaced. It's just a composite so it should be simple....
What kind of composite is it? Is it a resin composite or an amalgam with mercury?
You might want to read this article before Wednesday to have a topic for discussion with your dentist.
https://www.alternet.org/personal-health/when-its-time-fill-your-cavities-all-options-are-toxic
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NHMike wrote:We had three inches of heavy, wet snow and I did some pushing of it down the driveway. My son cleaned it up (carried it off). He helped me clear the lower roof as well. I used a roof rake with five sections to clear off a second story roof. It uses a lot of upper back, shoulder and chest muscles. We'll see how my muscles feel in the morning.
Atoq wrote:NHMike wrote:We had three inches of heavy, wet snow and I did some pushing of it down the driveway. My son cleaned it up (carried it off). He helped me clear the lower roof as well. I used a roof rake with five sections to clear off a second story roof. It uses a lot of upper back, shoulder and chest muscles. We'll see how my muscles feel in the morning.
What did they told you at the start? They told me not to lift anything that is heavier than 1 kg for several weeks...they scared me to death about brook in both muscles and stomy. Not the doctors but the nurses specialized on stomy. Is that the same for everyone? Even if the evening before surgery I was lifting or doing squats with more than my own weight?
Claudia
Atoq wrote:Thanks for the reply, I was a bit unsure about stretching as well.
Claudia
NHMike wrote:For those with a chest port, what's the chest port like, roughly where is it located and how careful do you have to be with it?
Also, I understand that the needle used for infusions is rather large. Is this needle plugged into the port for the infusion? Also, how large is the needle?
Shana wrote:
I have a power port, it's purple and not very big. It's inserted in the right side of my chest below my collar bone. The needle doesn't feel big to me when it's inserted, I like the fact that they always get it in first try and it does stay inserted during the entire infusion time. There are sprays that you can ask them to use prior to insertion but I stopped doing that when I ended up with an itchy rash. I just take a breath when they insert the needle and it's done.
I was very protective of the port initially because it was new to me. Once the incision heals then it's basically a non issue, I sometimes forget that it's there unless I am looking at it or brush my hand over it.
NHMike wrote:For those with a chest port, what's the chest port like, roughly where is it located and how careful do you have to be with it?
Also, I understand that the needle used for infusions is rather large. Is this needle plugged into the port for the infusion? Also, how large is the needle?
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