Night time leak

Hi and welcome to the online community it's nice to see you making your first post albeit to tell us about your first leakage experience.

I'm glad that by reading about our experiences prepared you for your 3 am adventure.

I'd like to congratulate you on your excellent stoma management that has enabled you to come this far without mishap you should be very pleased with yourself and not smug in anyway.

It"s just a reminder that none of us should feel complacent but to always be prepared for the unexpected.

Going forward you need to think why the leak happened was it something simple like overnight your bag was too full whilst you were sleeping or has your stoma changed size and you need to check the size of the hole cut, could it be that your body has changed slightly. Little things like these can creep up us without us noticing and problems start so it is always worth checking your stoma and peristomal skin every so often.

Hopefully maybe just a once off and your reversal date will not be too far in the distant future.

Now that you've dipped your toe into poo corner we can look forward to hearing further from you especially leading up to your reversal and the time after as we do like to know how others face the reversal and how they managed afterwards.

Well done again, you certainly should feel proud of yourself in achieving such good stoma management, pleased our stories prepared you for your first (and last) 3 am adventure.

Ian

CC

Thank you! I will definitely check my stoma size. I think it may have been a simple bag too full problem. ( judging by the amount of mess!)I ate later than usual and went to bed earlier and was very tired. I  do remember reading on one of the posts that it better to eat earlier in he evening. As I am at home not doing much ( on chemotherapy) and go back to bed for an hour or two after breakfast. I quite often don't go to bed till 11 or 12 sometimes so I empty my bag quite late on and have been managing till morning. I shall be a little more careful now.

Thanks again, your posts are always so helpful, I  have gleaned loads of tips and information!

I'm sure now I have joined the community I will have quite a few questions and queries.

Good Evening (well it is in Maryland, USA),

I am in desperate need of help.  I have had my ileostomy for 38 years now.  On February 6 I had surgery to remove adhesions that were constricting my bowel.  My bowel was also constricted just under the abdominal wall from my stoma.  The surgeon had to remove that part of my bowel and create a new stoma.  I had a beautiful little pink stoma before surgery,  Now, I have a large stoma with suture granulomas all around it.  Because of these granulomas, I can not get my appliance to adhere properly.  I have to change my pouch sometimes 3 times a day.  A couple of times I was able to go 3 days before it needed to be changed.  I have seen the ostomy nurse at our wound care center.  She has been very helpful with suggesting different supplies to help with the leaking.  However, I am still having problems.  Has anyone had any similar issues and could offer any advice?  The skin under my adhesive is beginning to get irritated and that also adds to the problem with the leakage.  I have ordered Convatec Duoderm Wafers and Skin barrier caulking strips.  I have never felt this hopeless with my ostomy.  I need help from someone who knows what I'm going through.

Any help would be greatly appreciated.

Thanks!

A very warm welcome to you, it's always a pleasure to welcome someone from the USA into our online community and especially into stoma support although the reasons why you have jumped across the water are not so pleasant but hopefully I can give you a UK take on resolving the problem.

I've had a look at the products I will be mentioning and they appear to be available in the USA and hopefully included in your Medicare scheme or similar.

I am assuming that your stitches have been removed.

Having had your beautifully nicely formed pink stoma for so many years to have further surgery to remove some adhesions and bowel then faced with one that bears no resemblance to your old one is a big shock, I know when it happened to me I didn't like my new one.

The best way to resolve the granuloma problem is to have them treated with silver nitrate which burns them off you skin, normally the procedure is done 2 - 3 times a week for a few weeks, I would assume that your ostomy nurse/WOCN at the wound care center would apply the silver nitrate for you or would you need to have a doctor do it. Unfortunately it does sting for a few  seconds afterwards whilst the healing process is underway Convatec have a paste that you should apply around your stoma, the paste is called Orabase and is formulated to absorb moisture whilst at the same time soothing the skin and helping it repair, it appears that it has some medical properties as well.

With the usual warnings you could try Orabase powder lightly dusted over your peristomal skin to absorb any moisture, any broken skin could have the powder massaged into it until the powder forms a crust then you must ensure that all powder residue is completely brushed off.

You could also try applying a seal around your stoma.

As your stoma is now larger and you need to cut a larger hole the pouches you were previously using are not now suitable. You should try and get a pouch where the hole can be cut to 75/90 cm (25/35 inches) and still have a large area for the wafer to adhere to your skin.

Although pouches are almost the same in both countries with a few variations I'm sorry I can't suggest one

I hope that my UK take on resolving your leakages helps and you get back to normal soon.

Please keep in touch, it's always nice to hear from members of other countries, and let me know you are getting on and how you resolved this particular problem.

Ian

If you can't get Orabase paste or powder look for Stomahesive paste and powder both made by Convatec 

CC

Ian,

T.hank you so much for the wealth of information.  I had a terrible day yesterday and this morning.  I have changed my pouch 4 times since yesterday morning.  My skin is so red and irritated.  My home nurse is coming tomorrow.  I am definitely asking her to order the powders and pastes you have recommended.

Just one question. Once you the silver nitrate is completed, how long does it take for the granulomas to be gone?  I am supposed to return to work on March 23 and I am quite nervous about it.

An abundance of thanks to you,

Judi

Hi Judi

Thanks for coming back, sorry to hear that you are still having problems on a grand scale.

I would suggest that when your home nurse is with you she gives you a full review of your changing regime which should involve her you watching every action you take including any products

- Adhesive remover either spray or wipes

you use to remove the old pouch. She should observe the way you clean your skin and what you use. She should then observe your procedure for applying a new pouch.

How you measure your stoma.

Cutting out the hole

What you use to prepare your skin

- Barrier Film

- Stoma paste

- Stoma powder

How you apply your pouch

She should observe everything you do and make any recommendations to solve any problems.

When cutting the hole in the barrier wafer you should make allowances for the granuloma, so it might be that you have cut the pouch hole slightly larger but if you apply the Orabase or Stomahesive paste around your stoma this should fill in the gaps, you could also apply a seal over the paste before you apply your pouch, if you find that your have to cut an irregular shaped hole in the pouch barrier take care should be taken to ensure the hole matches the shape of your stoma.

All the basics I'm afraid.

With the granulomas as soon as the treatment of 75% silver nitrate can be started the better with the first 2 to 3 applications the better, might have mislead you previous post, you may only need a few applications before you start to see results but you must use either of the pastes suggested whilst the treatment is ongoing and of course it won't do any harm to continue using them afterwards.

There is no guarantee that you won't experience recurring granulomas in the future and you should examine every time you change your pouch and if you spot one speak to your nurse and get a skin examination but the continued use of the pastes may  help to control them.

Returning to work, hopefully in the next two weeks we'll have the leaks under control but to be on the safe side there are things you can do.

Be upfront with your supervisor.

Ask if you can have additional locker space to store a change of clothes, spare pouches and any accessories you use. Remember to keep restocking and replacing everything you use.

Ask if you need to make special arrangements for disposing of your old pouches and the wipes used or is okay to place them in the washroom bins, they may have contaminated waste sacks that you can use.

If your workplace has special cubicles in the washroom for disabled people ask if you can use them and if they are key or code operated obtain the means to access them. In the UK ostomates have the right by law to use disabled facilities and is covered by an Employment act.

Hope everything works out for you today let me know how you get on and would be interested to know how the journey progresses.

We all know how frustrating it is to continually have leaks and how it can impede our quality of life but if we can shrug our shoulders, don't let it upset us, laugh it off and carry on we'll all be okay.

Ian 

CC

So sorry about your nocturnal leak and hope it was a one off. However, you might try “bananas”, extra strips that reinforce the connection of bag to you. Secondly, I wear a girdle at night that gives extra protection, containing most leaks. 

Thanks I shall ask my stoma nurse about them.

I have a polothene tbing connected to my bag to a plastic bottle the connectors are pluming connectors the system was devised in Salford royal hospital Manchester ward 8  I buy inco sheets on amazon I have to buy them the nhs wont buy them