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Thread: one of the most difficult days yet

  1. #1

    one of the most difficult days yet

    Had major breakdown with colostomy appliance MAJOR. Don't worry I wont show and pictures this time. Anybody have those bags figured out? Forget to apply adhesive to area right around stoma plus stool runny and like under pressure from deep inside so when it arrived and broke through the adhesive there was nothing I could do but sit there in shock. Called nurse, I did not want to wheel out of the bathroom and leave tracks all over the house. A nurse came over(home health) and this one put the appliance on with that stuff in a tube like caulking. Not too sure about this colostomy I got a month into it. Miss the times when there were no bowel issues but those times were fewer last couple years.

  2. #2
    So sorry you had to go through this. The stoma paste the new nurse used is fairly standard, and may be something you should be using routinely when changing your appliance. Hang in there. You will find a method of appliance application that works for you with a little trial and error and consultation with the ostomy nurse when needed.

    (KLD)

  3. #3
    If it's really runny take some Metamucil everyday. I take a tablespoon after dinner and really helps firm up the stool. I use a Hollister adapt ring around the opening of the appliance. Heat it up and form around the opening. It really seals the appiance; probably like the caulking does.

  4. #4
    Been there, done that. If you are still using ostomy paste (which is not really a paste at all), you may want to change that out for "barrier rings, Eakin seals, or paste strips." These are made of a different material than the ostomy paste and seem to fare much better for many people. You can call any of the big manufacturers (Hollister, Coloplast, or Convatec) and get samples sent to you.

    If you have recently had your surgery, you may need to re-measure the stoma and cut the hole a little smaller each time. If the hole is too big, this can cause blowouts such as this. You should be measuring at least weekly or each time you are changing your appliance, depending on your healing rate. I had to measure longer than a month for my stoma to finally arrive at its smaller size - at least two months.

    Talk to a home health nurse or over at UOAA Discussion Boards about considering a "convex" system. The nurses here may know a thing or two also. A "convex" system is used to make the stoma protrude more into the pouch to avoid issues like this. There is some discussion that "convex" systems should be used selectively in patients fresh out from surgery, as they can be more painful than flat systems and may cause other issues. Later after healing it should be no issue to try them. Again, you can ask for the big manufacturers to send you samples of convex systems (and they may know how soon their company recommends trying a convex system).

    Sometimes blowouts will happen even with everything being right. It took me a year to get a good system, then the manufacturer changed it and I had issue after issue, finally forcing me to change to a new system and new manufacturer. With the new system I have only had a few blowouts, some related to new foods I ate, some related to not changing the system soon enough (trying to get it to last one more day), and some with no known cause at all. So, even if you do everything right...it may blow out. But, I have confidence that eventually you'll find a system that works for you.

    A couple of suggestions: It might be handy to grab a towel and/or washcloths to keep a mess contained, if nobody is available to help you. The cr*p will then go onto the towel while you get a new bag, etc. and you can just throw the towel in the wash after you're all cleaned up (might be easiest to take an unplanned shower to clean off). I have also heard of people making a "stoma cap" out of a shaving cream cap or margarine tub to keep the rest of their body clean while they are changing the pouch after a shower. These options would attach to you via an ostomy belt (you might have to punch a couple strategic holes).

    I keep my supplies (to cut a new bag, etc) in the bathroom, and then a box of bags readily available in a room beside the bathroom. If I get multiple boxes (like a 3 month supply), I can tuck the additional boxes somewhere where they fit better. It is important for the ostomy supplies to be in a temperature-stable room, i.e. not in the bathroom where they are subject to high heat (warmth melts them, a bit of warmth makes them easier to adhere but you don't want them to warm up before they are needed). The same way if you have significant cold climates where you live....you don't want to subject them to too much cold on a regular basis. It may affect the adhesive.

    Maybe something in this helped. I am sorry this happened to you, but glad you still had home health available to call.

    Take care,
    Mystery

  5. #5
    Senior Member pfcs49's Avatar
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    My colostomy is super predictable until those rare diarrhea episodes happen. Sometimes you just have to go with the flow (pun intended).
    When a rapid overload of mud fills the bag, the results are predictable! I had my waterloo just outside the Holland Tunnel coming out of the city. We had met the daughters new in-laws at an exclusive steak house. Evertything went well, and as we were leaving, the bag began filling up with those manageable little hard ball-turds that I duly brushed into the bottom of the bag. Business as usual. Leaving the tunnel, I passed a bunch of gas and the bag inflated. I warned my wife that I was going to "vent" a little, rolled down my window, and unsnapped the top of the flange. BAZOOM!MUDSLIDE! I turned the courtesy light on with my clean hand. My lap was full of shit, my shirt was blasted, my hand was loaded with it, we were 35mi from home and we didn't have but a couple kleenex! It was a long crappy ride home.
    Lately, seems acceptance is usually the major solution to most problems, along with new information-like always have an abundance of cleaning supplies; tread softly-it may not be gas! Is the pouch half full or half empty-doesn't matter, empty is always best (I now routinely and without drama go into the bathroom, even in public places, and keep mine empty. Sometimes I make it to 4 days with a single pouch which is when I change the base,
    When I started I used the gooey ring stuff at the inner edge of the interface; I had some leaks; I started using the 3M Cavilon in a spray on applicator and have had virtually no problems with de-lamination since. Occasionally I'll find there was a little migration out under a bit of the flange, but in the last two years, no flange leaks. I spend a couple minutes after sticking the flange on pushing in on it and massaging the inner periphery; I hunch this heats up the thing, as well as the pressure, and helps to promote better adhesion.

  6. #6
    Thanks a lot for the feedback. I got my colostomy done last month and am still getting used to it. The blowout was a combination of the most powerful BM so far and not enough adhesive applied. Yes it was my waterloo. I am going to research a better ring around the 70mm stoma and a few other things I learned tonight, thanks again. Another good thing this thread has shown me is that this colostomy is my responsibility and I am probably going to have some more trial and error experiences but I am going to try really hard not to.

  7. #7
    Senior Member lynnifer's Avatar
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    Making me hella nervous reading this as I'm probably looking at one.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  8. #8
    Quote Originally Posted by lynnifer View Post
    Making me hella nervous reading this as I'm probably looking at one.
    The problem was me last night. I cannot tell you the relief I feel that I am USUALLY not leaving "presents" wherever I go. That is an empowering feeling Good Luck with what which direction you decide

  9. #9
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    I am like you, Lynnifer. Scheduled irrigating doesn't help control accidents?

  10. #10
    Senior Member lynnifer's Avatar
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    Yeah, I've read Scott's experience and thought okay maybe ... I believe he irrigates his daily.

    I've waited and waited for science to come up with something .... there's that epidural stim but who knows if it improves bladder/bowel control. It's too late for me .. stopped peeing blood with antibiotics. Think my bladder is totally shrunk and the foley cath end is irritating it. No more mucous, blood clots, reddish water. For now.

    Not looking foward to new holes to pee or poop out of ... Christ.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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