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Change wafer or let skin heal?

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Posted 1/30/2018 8:25 AM (GMT -5)
I got my loop ileo last Wednesday, and my skin looks pretty good, but it’s a bit sensitive, and there was a little yeast I am treating with a powder.. The ostomy nurses said I should just go back to my twice weekly changes. I changed everything Sunday night, and yesterday I could tell it wasn’t ideal. I think I either cut the wafer opening a tad too small, or my stoma swelled a bit. It’s not enough to cause real discomfort, but I can see the ring is pushed against the stoma a bit more than normal. I’ve also had some itching under the wafer, which could be a sign of output leaking under the stoma, healing skin, or a sensitivity to the wafer.
So, I’m debating whether I should leave it alone to let the skin keep healing, or change it a day early to see if the wafer opening is causing issues (which it might not even be ... could just be healing discomfort).
What do you all think?
Posted 1/30/2018 5:03 PM (GMT -5)
I got my ileostomy on 17/1/18 after nine healing of fistulas and incontinence. I have Crohn’s disease and had removal of large bowel and J.Pouch formation back in 1988. These fistulas have caused problems. Had seton drains and LIFT procedure done 3 times but no success...I hope my skin doesn’t get allergic to bags like it did 30 years ago. I hated it back then, but I was only 30 yrs old. Now I’m nearly 60 and more acceptable of it. I still don’t like it very much. But we shall see.
Wendy Hinde New Zealand.
Posted 1/30/2018 8:57 PM (GMT -5)
I don't know what I would do. I used to try to wait with my loop, but it's hard to wait when you have the stinging, and you think it's a leak, especially if you also feel like it's squeezing too tight. I would probably change, against my better judgement. I used to always change and then the burning wasn't really caused by much of anything. it would be literally 1mm around the edge, but you never know unless you change & with the tightness, you don't want to risk a block. Hopefully you change and everything's comfy, and you get a longer wear-time. Just a warning, I never got more than a day or two our of my loop set-up. I tried everything. finally I decided I might as well just wear a one-piece because I was changing so often.
Posted 1/31/2018 2:18 PM (GMT -5)
I’ve had the problem before with changing against my better judgment, so I was afraid of that too. I did change it, though, and it turned out to be a good thing. Either my stoma had changed size or I cut the last wafer too big, so there had been leaking below my stoma. I wasn’t sure at first whether it was redness or just the bottom part of the loop, but I sent a photo to my ostomy nurse, and she could tell right away. It was a mess ... couldn’t stop output during the change, so the red spot burned more and the top layer of skin peeled off, and it took a couple of tries before I got the stoma powder on. But eventually I got a new pouch on, and the wafer fits more snugly. I’m not getting the burning like I was before, and I’m hopeful that will continue. Then I can let the skin heal for a few days before changing. I was lucky and didn’t have any skin issues last time, so I don’t know much about managing them. Hopefully it will clear up quickly.
I’m amazed at how much energy the change took out of me ... guess I’m still recovering from surgery after all! smile
Posted 2/2/2018 4:57 PM (GMT -5)
Goodness, this is turning into a nightmare. I had thee leaks yesterday alone. Went to see a stoma nurse today, thought we got it worked out, then came home and had a blowout within two hours.
She confirmed there is a skin yeast infection, so I’m treating it with the right powder. It just itches like all getout.
I’m getting really discouraged about not being able to find a pouching system that will work.
Posted 2/2/2018 8:59 PM (GMT -5)
I'm using Hollister and works fine. Got to stay on top of fungus/redness. Not easy
Posted 2/2/2018 11:58 PM (GMT -5)
i can relate to a change taking a lot out of you. It's hard, especially after living with the end, which is so easy to manage. I never found a setup that worked with my loop. I struggled the entire 8 weeks I had it. I changed at least once a day. I felt like if I got a full 24 hours, it was a great success. After a while, I just used whatever supplies I had and accepted that I would be changing in the near future. I would use one piece systems, I used those firm rings often, and paste strips. I did everything and nothing helped. Luckily I didn't get yeast, but I did get it on my butt after takedown, so I can imagine how you're feeling with the itching there... don't stress. it is all temporary. You just have to get through this phase. I actually ended up on tears on the bathroom floor with my loop. I was so frustrated. I had to change in the middle of the night, and I couldn't get a moment break to put the wafer on.
Posted 2/3/2018 8:46 AM (GMT -5)
NSSG: I can’t imeagine wheat that must have been like to deal with issues for that long. I’ve already done the tears on the bathroom floor thing, and it’s only been a few days! My Coloplast setup has made it for 16 hours now, which is great. The downside is that the Hollister wafer seemed to let my skin breathe a bit more. Oh, well, I’m sure I’ll have a chance to try them out again soon! smile
Posted 2/3/2018 4:39 PM (GMT -5)
I was wearing a convex one piece moldable from convatec. I felt like that was easiest to manage since i was changing all the time. it's was only 8 weeks, and I didn't hit my breaking point until the 8 weeks was almost at the end. I just got so frustrated. I always felt like something would make it easier, but nothing did. You're still early on, and you've gotten 16 hours, maybe this is the start of a working setup for you!! I hope so! Don't get discouraged, even if you have to change everyday, it's not the end of the world. If I could just get 24 hours, and get on a schedule, it wasn't so bad. I think 24 hours between changes can be manageable. I always felt like a had a clean bag & that's nice. I also got into a groove with the one piece, and I would have loved to get a week out of my hollister, like I did with my end, but it wasn't happening.
Posted 2/4/2018 5:47 AM (GMT -5)
Changed bag yesterday with new medicated powder and skin getting better already. Dab a wipe over powder. It creates a seal over skin. Works well
Posted 2/4/2018 3:05 PM (GMT -5)
It's tough because everything seems so easy and manageable with the end ileo, then the loop is very difficult, mine was anyway. I've seen a few people here who have had loops for extended periods, and they seem to do well. Mine was the worst. I wonder if the doctors can purposely make the stoma a little longer if someone's keeping it a while? i think that would have made a world of difference for my loop.
Posted 2/4/2018 7:17 PM (GMT -5)
3timechamp, glad you’re making progress.
I had some progress followed by another setback, so I’m still feeling discouraged. My Coloplast setup made it for 24 hours, and I decided to change to a Hollister on the theory that the fabric wafer would let my skin breathe a bit better. And had a blowout within two hours. So then I changed back to Coloplast and will just hope the skin heals well anyway. It was a terrible change, because I had eaten recently, and everytime I got clean and dry, my stoma would go off again. The output is still really liquidy, and my stoma points down enough that there’s no real way to protect my skin during a change. So the skin that had been looking better was burned almost raw by acid. I finally got it dried off and covered in the yeast powder, and it’s feeling better now, so hopefully it wasn’t a long-term setback.
NSSG: Its definitely hard after the end ileo, and I think my pride is a bit damaged. I feel like I should be able to care for my stoma better at this point, even though it’s a little different.
Posted Yesterday 11:36 AM (GMT -5)
Good news. I changed my setup today. It made it for two days with no leaks, and since I changed first thing in the morning, there was no output to battle. My skin is looking much better. I am sticking with the Coloplast, and keeping my fingers crossed that I can settle into some sort of a routine.
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