History of my Stoma
Updated
23/11/2009
A potted history, mine was
formed on 4th December 1994 due to the the removal of a Tumour on my
ring
muscle.
The muscle had to be removed, and a permanent Stoma was formed. I was
given an 85% success diagnosis after
surgery. It was then a matter of keeping my fingers crossed that none
of the 15% chance would occur. I did not need any Radio or Chemo
therapy thank goodness.
The main thing is to be positive & get on with your life & accept your stoma, we would all rather not have one but !!!!!!
It is then a matter of stoma management, rather like having a new baby, a routine has to be developed, or the baby rules you. Take advice from your stoma clinic, but try to develop your own way of doing things if YOU think you have solved a problem, then use that solution.
The main thing is to be positive & get on with your life & accept your stoma, we would all rather not have one but !!!!!!
It is then a matter of stoma management, rather like having a new baby, a routine has to be developed, or the baby rules you. Take advice from your stoma clinic, but try to develop your own way of doing things if YOU think you have solved a problem, then use that solution.
Many sources of
professional
advice say that a Colostomy requires a closed pouch which you would
change
as necessary, could be several times each day, or once a day. I was
started
with a drainable pouch (without filter, they were not available) from
the word go, I have
continued to use drainable ones upto the present date and I
am now in my 15th
year(Nov 2009).
I have progressed to a pouch with a filter to reduce the amount of
ballooning problems, some
filters work well, some do not acheive good results. Even with a filter
ballooning sometimes occurs.
My first pouch was
Convatec
ileodress+ (no filter), I tried pouches with changeable filters all
from
various suppliers (as free samples). Then I went on to the Convatec
Esteem
range with filter but in February 2002 I started getting problems with
the
pouch seams splitting, causing leakages. Convatec did not resolve this
problem for me, although I have a theory that it was due to me starting
to use peppermint oil which was attacking the seal. I came to
this conclusion
because the oil bottle instructions advised not to leave the dropper in
the oil bottle as it perishes
the rubber bulb. By this time I had lost confidence in the Convatec
product
& through my supplier Fittleworth went in search of a replacement
pouch.
This turned out to be Dansac Nova 1 Asymm 15-60mm Ref: 812-15 which I
am
still using at the present time, brilliant filter action. During early
2008 I tried various clipless versions, I did longer term tests on
Braun
& Dansac. I had to revert back to my Nova 1 with clip as the
clipless ones leaked when Stoma output was wet.
My Routine - is as follows
In the first year I had trouble finding a routine & was trying to change my pouch on the same three days each week - Sunday am, Tuesday pm & Thursday pm. A two & a half day period followed by a two day period then another two & a half day period. I found however that after two days the seal allowed "contents" to come in contact with my skin just below the Stoma creating a sore spot. I changed my one week routine into a two week routine. I now use pm times, usually starting between 7pm & 8pm (taking around an hour, including a shower without the pouch) Monday, Wednesday, Friday, Sunday, Tuesday, Thursday, Saturday & back to Monday. For some this routine may affect their Social Life. I do however occasionally vary the routine by slipping in a three day period or a one day period to adjust for a future event/holiday. Around this time I developed my pouch attachment technique - I remove the pouch, shower, hair shampoo etc & then wash the skin around the Stoma using Imperial Leather Soap. After rinsing thoroughly I exit the shower and keep as close to the toilet as is possible, I have a mirror stood so that I can keep an eye on the Stoma for output & yes I do have the occasional Disaster. I then lay on my bed with suitable pillows to allow me to sit up, keeping warm with a track suit styled jacket, with all my equipment set out on my left hand side (plenty of wipes, & additional disposal bags). My equipment consists of, a toilet roll, Stoma non sterile wipes by J & J (Topper 8) or free ones by Fittleworth (my chosen supplier), Simcare Chiron Barrier Cream (now using Coloplast Barrier Cream No.4729 60ml tube), Convatec Orahesive Protective Powder, 3M Cavilon no sting barrier film, Convatec Stomahesive Paste, a pair of tweezers, a New Pouch ready cut to fit & finally a Perfumed Disposal Bag into which are placed all used wipes etc.
The Procedure, take your time between processes, I have a small TV (now LCD with freeview) to watch in between - Rub a small amount of Chiron Barrier Cream all over the area that will be covered by the pouch gently rubbing in, remove any surplus using wipes, allow a couple of minutes before continuing, watch TV. Sprinkle over this area with Protective Powder, use wipes to evenly spread it around, then remove the surplus, watch TV, use Cavilon Barrier film (I use the one on sticks similar to a cotton bud) in a circle about 5 to 10mm from the Stoma but no further. I get the pouch (with Clip already fitted) from on my right leg where it has been warming, then apply a small amount of barrier cream through the cut opening & spread it around on the inside of the front of the pouch. As my Stoma is slightly concave on the bottom edge but normal skin level at the top edge, I apply a thin layer of Stomahesive Paste direct from the tube. Keeping the tube at right angles to the skin, starting on the right hand side of my Stoma I go under the stoma going around the Stoma in an anticlockwise direction half way around, this means I finish on the left hand side. I wet my finger to smooth down the adhesive to meet the edge of the Stoma all the way around. I then apply without much delay. I hold it in place pressing gently on the lower edge of the stoma to ensure there is no gap.
I then lay where there for a couple of minutes, watch TV. I then rise carefully from the bed sliding sideways & proceed back to the bathroom. Wash hands & the put all the equipment away. For the next hour or so try not to bend too much so that the pouch gets time to warm to body heat & provide a good seal.
I know this is a long drawn out process but it is my tried & tested method, a bit like cooking.
By the way I forgot to mention what the tweezers are for - don't use a razor, pull the hairs out using the tweezers, it does not hurt as the skin is soft, up to an inch (2.5cm) beyond the area covered by the pouch - this helps prevent any hairs getting under the adhesive area of the pouch.
November 2009 - These instructions are still current.
My Routine - is as follows
In the first year I had trouble finding a routine & was trying to change my pouch on the same three days each week - Sunday am, Tuesday pm & Thursday pm. A two & a half day period followed by a two day period then another two & a half day period. I found however that after two days the seal allowed "contents" to come in contact with my skin just below the Stoma creating a sore spot. I changed my one week routine into a two week routine. I now use pm times, usually starting between 7pm & 8pm (taking around an hour, including a shower without the pouch) Monday, Wednesday, Friday, Sunday, Tuesday, Thursday, Saturday & back to Monday. For some this routine may affect their Social Life. I do however occasionally vary the routine by slipping in a three day period or a one day period to adjust for a future event/holiday. Around this time I developed my pouch attachment technique - I remove the pouch, shower, hair shampoo etc & then wash the skin around the Stoma using Imperial Leather Soap. After rinsing thoroughly I exit the shower and keep as close to the toilet as is possible, I have a mirror stood so that I can keep an eye on the Stoma for output & yes I do have the occasional Disaster. I then lay on my bed with suitable pillows to allow me to sit up, keeping warm with a track suit styled jacket, with all my equipment set out on my left hand side (plenty of wipes, & additional disposal bags). My equipment consists of, a toilet roll, Stoma non sterile wipes by J & J (Topper 8) or free ones by Fittleworth (my chosen supplier), Simcare Chiron Barrier Cream (now using Coloplast Barrier Cream No.4729 60ml tube), Convatec Orahesive Protective Powder, 3M Cavilon no sting barrier film, Convatec Stomahesive Paste, a pair of tweezers, a New Pouch ready cut to fit & finally a Perfumed Disposal Bag into which are placed all used wipes etc.
The Procedure, take your time between processes, I have a small TV (now LCD with freeview) to watch in between - Rub a small amount of Chiron Barrier Cream all over the area that will be covered by the pouch gently rubbing in, remove any surplus using wipes, allow a couple of minutes before continuing, watch TV. Sprinkle over this area with Protective Powder, use wipes to evenly spread it around, then remove the surplus, watch TV, use Cavilon Barrier film (I use the one on sticks similar to a cotton bud) in a circle about 5 to 10mm from the Stoma but no further. I get the pouch (with Clip already fitted) from on my right leg where it has been warming, then apply a small amount of barrier cream through the cut opening & spread it around on the inside of the front of the pouch. As my Stoma is slightly concave on the bottom edge but normal skin level at the top edge, I apply a thin layer of Stomahesive Paste direct from the tube. Keeping the tube at right angles to the skin, starting on the right hand side of my Stoma I go under the stoma going around the Stoma in an anticlockwise direction half way around, this means I finish on the left hand side. I wet my finger to smooth down the adhesive to meet the edge of the Stoma all the way around. I then apply without much delay. I hold it in place pressing gently on the lower edge of the stoma to ensure there is no gap.
I then lay where there for a couple of minutes, watch TV. I then rise carefully from the bed sliding sideways & proceed back to the bathroom. Wash hands & the put all the equipment away. For the next hour or so try not to bend too much so that the pouch gets time to warm to body heat & provide a good seal.
I know this is a long drawn out process but it is my tried & tested method, a bit like cooking.
By the way I forgot to mention what the tweezers are for - don't use a razor, pull the hairs out using the tweezers, it does not hurt as the skin is soft, up to an inch (2.5cm) beyond the area covered by the pouch - this helps prevent any hairs getting under the adhesive area of the pouch.
November 2009 - These instructions are still current.
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