Mom’s bag won’t stop leaking

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Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Mom’s bag won’t stop leaking

Postby Punky44 » Thu Mar 28, 2019 6:22 pm

My mom is a week out from her surgery and things seemed to be going ok until the first time we had to change the bag. We did everything by the book in terms of putting on the wafer/putty/bag, although I believe I made the mistake of cleaning the stoma too harshly—I made it bleed and now it has like a weird scabby crust all over it. Anyway, the next day it started leaking so we went to the local stoma nurse—she changed the bag and then this morning that bag is leaking. We went back today and she changed it again and now hours later, that bag is leaking. This lady has 35 years of experience so I KNOW she’s doing it right. What is going on?! Her explanation is the stool is just too watery and so it’s going to leak until things get regulated. She also wasn’t concerned with the scabby crusting over it. We are just at a loss. Is this normal?? Is this going to stop??
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Mom’s bag won’t stop leaking

Postby MissMolly » Thu Mar 28, 2019 9:08 pm

Punky:
Come on over to the United Ostomy Association of America support forum for assistance from its ranks of stoma-sporting members.

www.uoaa.org

A few ideas to get you through the immediate crisis of leaks:
1. Ostomy nurses are not all knowledgeable. You will find a number of individuals with ostomies who, when recounting their early days with a stoma, report disheartening experiences with WOCNs. Self-study and learning/sharing from others with an ostomy is the road to success.

Each of the main ostomy manufacturers (Hollister, ConvaTech, Coloplast) have 1-800 telephone numbers with trained customer service representatives. Do not hesitate to give a call to the supplier of the brand your mother is using. The 1-800 numbers are available on the UOAA forum.

2. A loop ileostomy (which your mother likey has) is the most diffcult of the ostomy types to pouch successfully. The larger/dual stoma and the placement of the stoma higher up the tract of small intestine contribute. The fecal output is high in digestive enzymes and highly liquid in consistency, which adds to a tendency for wafer leaks.

3. Skin
Be certain that the peristomal skin (skin around the aroma) is clean and dry before applying the wafer.

Do NOT use any soaps or body wash with added aloe or lanolin or essential oils. Preferred soaps: Neutrogenia soap for sensitive skin; Ivory bar soap; Cetaphal brand bar soap; any glycerin bar soap; Johnson & Johnson Basis bar soap.

Do NOT use any premoistened “baby wipes” or other hand wipes.

If you want a premoistened towellet, there are wipes designed specifically for ostomies. Ex. Safe ‘N Simple peristomal adhesive remover wipes, about $6 per package of 30 wipes (available from your ostomy product supplier as well as available on Amazon).

Warm the wafer before applying to the skin. A wafer is composed of pectin and a hydrocolloid matrix. It has no adhesive stickiness of its own. A wafer bonds to the skin by a reaction mediated by heat/body heat. Pre-warming a wafer aides in securing an air-tight seal. Use a hand held blow dryer on a medium setting, allowing the warm air to pass over the wafer for 30-45 seconds.

After applying the wafer to the skin place your hand over the wafer and hold in place firmly for 2-3 minutes. Use your fingertips to apply pressure to the wafer and to smooth its surface of any wrinkles or air bubbles.

4. Beware of ostomy/stoma paste
Ostomy paste is the single greatest misnomer that causes undue confusion and distress to new oatomates.

Ostomy paste is NOT a glue. It has NO adhesive qualities. Ostomy paste is not an adhesive material as its name implies.

Most people do NOT need to use ostomy paste. And yet almost every WOCN provides it to new patients and encourages it use.

What is the purpose of ostomy paste? It is meant to fill small divots or small creases in the skin to make a level skin surface. It is meant to fill small indentations in the skin. Ostomy paste is analogous to putty used to fill crevices between tiles in creating a kitchen counter or backsplash.

If you have been ostomy paste thinking that it is Elmer’s glue this is likely the source of your leaks. If you are making a ring of paste on the wafer, thinking that you are making a ring of glue . . . Stop and desist. A ring of paste, in this instance, is like a ring of cake frosting. Highly liquid and highly corrosive loop ileoatomy output will easily migrate through the ring of paste, undermining the wafer, and lead to distressing leaks.

What to use? Almost all loop ileoatomies will need to use what is called an “adaptic barrier ring” to prevent wafer leaks.

An adaptic barrier ring is a donut shaped sphere of silicone or hydrocolloid/elastic fiber matrix. It is placed around the stoma (or on top of the cut-out opening for the stoma on the wafer) and serves in function analogous to a gasket on a water facet.
Each of the main ostomy product manufacturers make their own proprietary line of barrier rings. The Top Pick, along most ostomates, is the ConvaTech Cohesive Ring Seals (regular or slim). Coloplast makes the Brava Adaptic Barrier ring.

You will want to become familiar with an adaptic barrier ring. Fortunately, YouTube has any number of videos that explain barrier rings and how to use them.

4. Finding the best ostomy wafer/pouch system is an individual process
The wafer/pouch system that your mother was provided with in the hospital may not be the best/optimal system for her. Hospitals contract with only one ostomy manufacturer, allowing them cost savings. However, every person has unique ostomy pouch needs based on the topography of his/her abdomen, skin characteristics, shape and length of stoma, incision line, etc. Each of the ostomy product manufacturers have unique differences in the design and composition of wafers, pouches, and accessory supplies.

It is beneficial to call the manufacturers and request product samples to find the best pouching system for each person. This is time well invested, even if the stoma is temporary.

5. Use of an ostomy belt or belly binder
An ostomy belt is a 1/2” wide length of elastic that attaches to clips to both sides of an ostomy wafer. It holds the wafer close to the body, minimizing friction and movement that can loosen the wafer/skin bond and cause leaks.

A belly binder or belly band is analogous to a maternity belly band. It is a 7”-10” wide elastic band that fits around the abdomen. Its mild inward compression helps to hold the wafer/Pouch close to the body and minimize movement that might contribute to leaks.

5. Body type
A “fluffy abdomen” with folds of adipose tissue will be more
challenging to pouch than a flat abdomen.

A fluffy abdomen will often do best with a thin/low profile wafer as compare to a convex wafer. Thin/low profile wafers include the Coloplast Mio wafer and CyMed MicroSkin wafer. The Coloplast Mio Flex is a new addition specific for those with rounded/protruding abdomens or prominent hernias.

Here again, talking to the customer representatives at any of the ostomy manufactures can be hekpful. These people know their stuff.

OK . . . A few ideas to help you trouble-shoot. My sense is that the source of the leaks is from over-generous use of ostomy paste (thinking that the paste is a glue-like adhesive, which it is not). Or that you Mother is using a wafer that has convexity and rigid.

The members of the UOAA will also be able to problem-solve with you.
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Mom’s bag won’t stop leaking

Postby Punky44 » Thu Mar 28, 2019 11:52 pm

Thank you, this is super helpful.

The weird thing is—we were using the barrier ring and it was doing okay until Tuesday and since then, the ostimy nurse had us switch to the paste. But from what you’ve described, that doesn’t sound like a great idea. Tonight we switched back to the barrier ring. I also saw something about cutting the wafer hole slightly larger than normal? So we tried that, too. I’m “on call” tonight if it leaks. Here’s to hoping.
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

User avatar
O Stoma Mia
Posts: 1709
Joined: Sat Jun 22, 2013 6:29 am
Location: On vacation. Off-line for now.

Re: Mom’s bag won’t stop leaking

Postby O Stoma Mia » Fri Mar 29, 2019 2:26 am

MissMolly's post is precious. It contains all of the essential information to start managing stoma bags.

For future reference, here is the direct link (Post Bookmark) for her post. You can save this link somewhere so that you can easily find this reference when you need it again, later on.

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=62127&p=490424#p490424
Last edited by O Stoma Mia on Fri Mar 29, 2019 11:48 am, edited 1 time in total.

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Mom’s bag won’t stop leaking

Postby Punky44 » Fri Mar 29, 2019 11:15 am

Thank you!
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

Pyro
Posts: 305
Joined: Mon Oct 12, 2015 7:40 pm
Location: Tucson, AZ

Re: Mom’s bag won’t stop leaking

Postby Pyro » Fri Mar 29, 2019 10:04 pm

#4 above for certain, it took me about a year and 5 different bag systems.
Aug 2015- Stage 4 CC with liver Mets(38/m)
Sep 2015- Avastin/Folfox/Iron
Dec 2015-Not liver surgery candidate
Jan 2016- Erbitux/Folfiri, 2nd opinion at MDA in TX
Feb 2016 -MDA liver surgery
Mar 2016 -30% of left lobe rem, PVE
May 2016 - 70% of liver rem
Jun 2016-Rad
Jan 2017-perm colost @MDA
Jul 2017-Erb/FOLFURI
Nov 2017 -Lung & Liver ablations@MDA
Jan 2018 -Xeloda & Avastin mx
Jul 2018-Avast/FOLFURI
Sep 2018-Rad
Mar 2019 - Keytruda fail
Jun 2019 - FOLFURI
Aug 2019 - No more, quality time!

User avatar
O Stoma Mia
Posts: 1709
Joined: Sat Jun 22, 2013 6:29 am
Location: On vacation. Off-line for now.

Re: Mom’s bag won’t stop leaking

Postby O Stoma Mia » Sat Mar 30, 2019 1:00 am

Punky44 wrote:...I’m “on call” tonight if it leaks. Here’s to hoping.

Just checking... How is the leak situation now? Still having problems?

If leaking turns out to be a chronic problem, there are all kinds of temporary solutions you can try. For example, you can add extra bandaids or wide tape in the area or in the skin folds where the leaks tend to occur.

In the link below you can see the wide range of ostomy products available from different suppliers, including some semi-circular band-aids (see Nu-Hope tape strips in the link below) . Even a roll of wide micropore tape can come in handy to patch up a leak temporarily until the morning when you have more time to properly change the wafer.

https://www.brucemedical.com/tapadandrem.html

Also, you might want to read some of MissMolly's earlier posts about chronic wafer leaks:

https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=55189&p=438310#p438310

https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=58013&p=456986#p456986

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Mom’s bag won’t stop leaking

Postby Punky44 » Sat Mar 30, 2019 10:56 am

O Stoma Mia wrote:
Punky44 wrote:...I’m “on call” tonight if it leaks. Here’s to hoping.

Just checking... How is the leak situation now? Still having problems?

If leaking turns out to be a chronic problem, there are all kinds of temporary solutions you can try. For example, you can add extra bandaids or wide tape in the area or in the skin folds where the leaks tend to occur.

In the link below you can see the wide range of ostomy products available from different suppliers, including some semi-circular band-aids (see Nu-Hope tape strips in the link below) . Even a roll of wide micropore tape can come in handy to patch up a leak temporarily until the morning when you have more time to properly change the wafer.

https://www.brucemedical.com/tapadandrem.html

Also, you might want to read some of MissMolly's earlier posts about chronic wafer leaks:

https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=55189&p=438310#p438310

https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=58013&p=456986#p456986


Thank you so much! We made it 24 hours without a leak but then had another last night :(. It’s always in the same spot! Her output is extremely watery and she was actually hospitalized for dehydration on Wednesday.

I ditched the paste and am using the barrier rings as suggested above and we seem to make it longer with those. I will definitely look into these bandaid products—thank you!! On the other end, I am trying to encourage her to actually drink less water and more electrolyte solution bc right now she’s probably 45oz water, 25oz Gatorade. And I’m seeing if we can see a difference by flipping that to only 16 oz water and the rest Gatorade. Also really trying to push more and more thickening foods because one banana isn’t doing it. Also, she tends to be a “contortionist” with the way she sits and relaxes at night and this is usually when the leak occurs so I am trying to encourage her just to sit like a normal person instead of rolled in the fetal position with a leg up.
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Mom’s bag won’t stop leaking

Postby MissMolly » Sat Mar 30, 2019 11:21 am

Punky:
A word of caution on Gatorade and PowerAide . . . .

Energy drinks with high added sugars and high fructose corn syrup will add to problems with diarrhea and excessive water loss for those with a new ileostomy. Gatorade and Powerade and similar are NOT your mother’s friends. Do NOT place these beverages in your grocery card.

The problem: High sugar content causes gastric dumping.

A far better approach to hydration is to use Nunn’s Tabs or Cera-Lyte. Both can be found on amazon. Cera-Lyte is a Top Notch Medical grade rehydration mix. They have one formulation specific to those with ileostomies. The Cera-Lyte home web page is informative.

Nighttime is more prone to wafer leaks due to the pooling if liquid fecal output around the stoma when lying down.

To help minimize nighttime wafer leaks:
1. Have an early dinner (5 pm) and keep the meal small. Sips of fluids before bedtime.
2. Purchase a wedged-shaped bolster for the head of the bed or look into an articulating bed frame. Foam wedged-bolsters are available on Amazon and local home medical supply stores. You want to have your mother sleep with her head and upper torso elevated so to minimize pooling of liquid output around the stoma and wafer opening.
3. Purchase gel packets for the ostomy pouch that serve to coagulate liquid decal output into a gel consistency. There are a number of products available from your ostomy supplier. They are packets that you place in an empty pouch that have that effect of turning liquid effluent into a gel consistency. The less liquid the fecal output the fewer the leaks.

Place a new wafer on your mother when she is lying flat on the bed. Lying flat will have that advantage of creating a flatter abdominal surface for applying the wafer, especially if your mother has a “fluffy” abdomen or skin folds and creases.

Wafer leaks should be an exception and not a general or frequent occurance. I probably have about 2 wafer leaks a year.
So know that wafer leaks are NOY something that you have to live with.

I encourage you to contact each of the main ostomy product manufacturers (Coloplast, Convatec, Hollister, CyMed) and discuss characteristics of your mother’s stoma and skin topography with a customer representative. All ostomy supplies are not the same. There are literally hundreds of diffeeeent waters and pouches and barrier rings and permutations therein. Finding the Best Fit of an ostomy pouching system makes all the difference in living a quality life with a companion stoma.

Keep in keeping on,
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Mom’s bag won’t stop leaking

Postby Punky44 » Sat Mar 30, 2019 11:43 am

Thank you! So we are only buying Gatorade Zero with no sugar or high fructose corn syrup—do you think that’s okay? Another question—should she be eating ONLY thickening foods until this firms up or...?

Thank you for these other tips! We do put the wafer on lying down flat—she’s super thin (110lbs and honestly probably less now with all this going on)—are there certain wafers and rings that work well on ultra thin people?

Does the fact that it’s always leaking in the same spot imply anything?

Another question—is this “common” in the early days after surgery or is there something very wrong here? We are both freaking out that it’s going to be like this for the next three months if we can’t find a solution that works.
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Mom’s bag won’t stop leaking

Postby MissMolly » Sat Mar 30, 2019 2:18 pm

Punky:
Gatorade with no added sugars may be fine. I am not a fan of foods where I cannot understand a list of ingredients or foods with chemical additives. I purchase at Whole Foods.

Your mother’s intestinal tract has been traumatized by the recent surgery. Keep in mind that foods that are highly processed or with additives or colored dyes may be more irritating to her digestive tract while it heals. I am a big proponent for quality foods while healing. Nunn’s Tablets and CeraLyte you can trust as a rehydration aide and not to add insult to the digestive tract.

Loop ileostomy output, by nature of its placement higher up the small intestine than other ostomies, will be of a thin, liquid consistency and fairly high volume for its duration. The water content of digestive material is higher in the upper portion of the small intestine then it is at the terminal end of the small intestine (end ileostomy placement) or large intestine (colostomy placement).

The use of Imodium liquid or caplets can be helpful in slowing the volume of loop ileostomy output. One caplet taken 30 minutes before a mini-meal. Some people will take 6-8
caplets a day to control for high volume output. However, be careful . . . as too generous dosing can lead to rebound constipation by slowly the intestinal tract to a crawl.

That the water leak is occurring in the same area is good detective work. It likely means that this area is under more tension/stress and weakening the skin/wafer seal. Ex. It may be an area that is stressed when your mother bends over, as in tying her shoes, or when she reaches to the side. It may also be an area where the skin folds when she sits. In looking at a circular time clock, can you describe to me where the leak occurs? Is it at the 2 o’clock position? 4 o’clock position?

Possible remedies:
A. Have your mother move (bend, reach to the right and to the left, etc) to see if you can recreate where the stress that is leading to the wafer leak. Is there a skin fold in sitting that is not apparent when she is lying flat?

Building up the area with an additional wedge or pie-shaped piece of adaptive ring is often a strategy to correct for a leak. The adaptive barrier rings are easily trimmed and cut with a pair of scissors. A wedge or pie-shape piece superimposed in the full adaptive ring can often reinforce an area prone to a leak.

2. Use a hair dryer to warm the wafer/barrier ring prior to placing on the skin.
The wafer + skin bond is mediated by heat. Warming the wafer/adaptic ring with a hand-held blow dryer for 45 seconds-1 minute can make a big difference in enhancing the seal.

3. Type of ostomy pouching system used
Ostomy pouching systems come as one-piece (wafer and pouch attached as a single unit) and two-piece systems (wafer and the pouch are separate units and connect with a Tupperware type locking system or adhesive coupling system).

Two-piece systems tend to be more rigid owing to the coupling system necessary. Rigid systems lack inherent flexibility to move as the body moves and are more prone to wafer leaks. For small/petite people, the larger size and rigidity of a two-piece system can lend to more problems with leaks. Small/petite people often do better with a one-piece system with a low profile (no convexity).

I am more child-sized than adult sized. I use the Coloplast Mio one-piece and the CyMed MicroSkin one piece systems. I actually use their pediatric sized products. The Coloplast Mio wafer has elastic polymers imbedded in the hydrocolloid matrix, allowing a unique design that contours intimately with the contours of the skin and moves as the body moves.

Key in minimizing leaks is a secure wafer/skin bond mediated by adequate warmth, a wafer that contours closely to the topography of the skin, and a wafer that is thin and flexible that moves naturally with the body.

Bulky two-piece ostomy systems, rigid convex wafers, and inflexible Tupperware coupling between the wafer and pouch all add to a likelihood of leaks.

If you venture to any ostomy supply company (such as Byram Health care or EdgePark or Sterling Medical or StomaBags) and browse through the ostomy products available you will be amazed to see hundreds of products. Hundreds. No two people are alike. No two abdomens are alike. The great wrath of products available speaks to the individual needs of each person in finding an ostomy system that is “The One” for his/her personal needs. Taking time to find the best match for your mother will be well worth the time. Start by calling each of the main manufacturers (Coloplast is my personal favorite). The 1-800 numbers are available on the UOAA web site.

Hang in there. It does get easier.
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Mom’s bag won’t stop leaking

Postby Punky44 » Sat Mar 30, 2019 3:22 pm

Thank you so much! These are great ideas.

So when I’m looking at the leak from my viewpoint, it’s between 7 and 8 oclock.

We are currently using a two piece system where I have to connect the wafer to the bag. I will definitely be calling Coloplast bc it sounds like this one piece low profile system may be way better for her body type? We are amazed at how big this bag is! She says it hangs down so far, cuts her at her thighs and she doesn’t think she could ever wear anything but sweatpants and baggy tops for the next three months to hide it.

I am interested to try the experiment of having her “scrunch” up like she often does and see what it does to the 7/8 o’clock spot. So are you saying I can cut a sliver off the putty and just build an extra putty layer around that area? Any pics or videos you know of? And with the hairdryer, is that before we put it on or after?

Thank you again!
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Mom’s bag won’t stop leaking

Postby MissMolly » Sat Mar 30, 2019 4:10 pm

Plunky:
I adore Coloplast and have been a loyal customer. I was started on Hollister in the hospital and had problems from the get-go with leaks and always having a slight odor to me. Coloplast was like a shining rainbow for me. I can now live my life without worry about my ostomy.

Here is the Coloplast web site. You and your mom might want to sit and browse. Their marketing is crisp and easy to assimilate.

www.coloplast.us

I wear a one-piece Coloplast Mio with a 6 inch pouch. The wafer is thin, low profile, and malleable. Elastic polymers give the wafer an inherent flexibility not found in other manufacturers. I barely give any notice to my ostomy wafer/pouch during the day, it is close to feeling as though I am wearing no pouch at all.

The 7-8 o’clock leak position suggests tension in the water as your mother is sitting. It is a common area for leaks (as well as the opposite 4-5 o’clock position).

I use a hair blow dryer with every wafer change to enhance the seal with the skin. The wafer+skin bond is heat mediated. Here is no inherent stickiness to a wafer. Heat/warmth is key to getting a solid air-tight seal.

Yes, you can cut a triangle or wedged shaped piece of an adaptic barrier ring to use as a reinforcement in the 7-8 o’clock position. You would add this in addition to the full adaptic ring.

I place the adaptic barrier ring around the cut hole in the wafer and use the pressure of my fingertips to push/mold the adaptive ring into the hydrocolloid surface of the wafer. Give it a good amount of pressure.

Then use the hair dryer with hr air flow over both the adaptic ring and the hydrocolloid wafer as a whole. Press the adaptive ring into the hydrocolloid surface, again, using your fingertips as the materials begin to warm and soften. This is about a minute to a minute and a half of warm heating with the hair blow dryer. Do not be too aggressive with heating as you will melt the pouch. There is a delicate balance of warm heating - not too much but not too little. You’ll get the hang of it.

With the adaptive ring and hydrocolloid wafer warm and flexible, place the wafer over the stoma. Smooth any irregularities. Keep hand pressure on the wafer for 30 seconds to a minute to make a secure hold.

I try not stay relatively inactive for 30 minutes after placing a new wafer. After that, I am good to go.

Having a new ostomy is similar to caring for a new infant. Care for the stoma and skin takes patience and time. Pouching is a skill that takes time to learn. Each person needs to experiment with product samples to find The Best system for him/her.

It sounds like you are gaining in confidence. There is an answer to be found to the leaks. You just have to work like Sherlock Holmes in trouble shooting the issue. Try to find humor whatever you can.

Continue on, be well
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: Mom’s bag won’t stop leaking

Postby Lee » Sat Mar 30, 2019 4:26 pm

I have not read all the posts, butt I certainly ditto what Karen says.

Just going to add, Walgreen's has a water proof tape that I keep with me. I tend to wear my wafers for a week with out changing. I use the 2 piece system and just change the bags as needed. Sometimes on that last days, I see where I'm pushing it with the wafer, I use that water proof tape, I'm good for several hours up to a day. On a few occasions, I'm out and about, I see where wafer is starting to leak, I use that tape and I'm good until I get home. Walgreen's brand water proof tape.

I've been using the same ostomy product for the past 12+ years, they discontinued it last years. I've come to understand not all ostomy products are equal. Some truly are better than others, we are not all alike. My advice, call up places like Hollister, ConvaTec, and Coloplast (especially the SenSura Mio) and ask for samples.

Ditch the paste, those barrier rings are far better.

I was using Hollister, now using Coloplast, butt did talk to Hollister recently and vented my frustration with there new product line. They sent some some other products, one I am considering as a back up.

Anyway, living with a colostomy is a learning curve, butt is manageable. A friend recently told me, until I told her about my colostomy, she said she had no idea I had one.

Hope this helps,

Lee

P.S. I go under the name of Nickolas on the forum Karen suggested, if you have not already done so, do check it out.
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 16 years and counting!

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Mom’s bag won’t stop leaking

Postby Punky44 » Sat Mar 30, 2019 5:43 pm

Thank you again MissMolly and Lee for all of these helpful suggestions. One last question for now—if we end up switching to the Coloplast one piece (wafer/bag combo), would we still be able to use the Hollister barrier rings we already ordered? Or is there a special Coloplast ring that works better with its own brand?
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.


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