Recurring Leakage: Need Help Diagnosing

This is the 3rd time since Monday. It goes under the seal. Then leaks out the water. Then when I take it off, there are clumps and then it flows out. What am I doing wrong?

Make sure skin is dry, dry. Try a skin prep if you do not use one. I use an empty tape spool as a steam roller on the ring to make it get a good seal. I use the ring backing between the roller and the ring so the roller does not pull the ring off. Other people use heat to help it stick. Good luck.

Are you using a convex flange? If not, try one - it made a huge difference for me.

Laurie

Hi D,

I know we've talked about your leakage in the past, but I have no memory left. If you're not doing a lot of bending, exercising, etc. that makes the skin around your stoma do weird things, then there's really no reason you can't get a good seal. I'll just throw some things out there and see what sticks....

For your output to go under your ring, it would mean either your stoma isn't pointed straight out from your body, or something is obstructing the bag....meaning if your output can't simply fall out and down into the bag, something is forcing it to go under your ring.

Assuming you're not wearing a belt across your stoma or something else a bit stupid......what is directing your output under the ring. Is the ring behind your stoma (from the top looking down) or is it on the same level as your stoma? It needs to be behind your stoma so your output shoots out and over the ring....I know...duh. Even if your ring didn't stick well to your body........if your stoma extends past your ring surface, output would never get behind it. So we need to understand the physics of what you've got going on.

Is your stoma retracted? Meaning is the end of it that stuff comes out of actually lower than your skin around it? I could see where that would be a problem even with a convex barrier.

Are all your leaks occurring when you're laying down........or do you get leaks when standing? Do you get pancaking........i.e., thick non-liquidy output that you have to push down into the bag to assist it........or is your output always pretty free-flowing? I very rarely get pancaking, but when I do, my output can work its way under my ring, as my stoma points to the right.....right into the side of my ring. I'm assuming your stoma sticks straight out though.

When you remove your barrier to change it on days you have no leakage, is the adhesion to your skin any different than when you remove your barrier after a leak occurs? I'm talking about the part of the barrier that has not leaked..........obviously where the leak is you have no adhesion. I'm trying to see if adhesion is playing any part in this or if it's the physics of how your stoma is aimed and where it directs your output.

Again, you've probably already answered most of my questions, but it might be easier for everyone if we recall where you're at with what I've asked. There's an actual nurse with an ostomy on here now that can probably help get to the bottom of this mystery as well.....so it will be new info for her too.

Regards,

Bob

It has leaked lying down, sitting, and standing. It leaked from the side, and I have a scar from gall bladder surgery. I do get pancaking. It usually is liquid. My skin is irritated for some time. It was getting better with calamine. I haven't had a chance to use it for a while, quick changes. The skin has the same leakage or not. It needs time to heal. It's like it backs up under seal and leaks liquid out. Then I change it, and it is non-stop. Thank you.

Danders,

You really need to consult an ostomy nurse if this is continuing to happen. You seem to be having multiple issues over a fairly short period of time. We can only give you suggestions on this site, but you need to have someone with some expertise looking at your stoma, the skin around it, and the equipment you are using, in order to find a solution. A stoma nurse needs to be your first line of defense right now. I hope you can see someone soon.

Laurie

I have seen her. She switched my Eakin seal to silicone. She is not the greatest.

Maybe time to switch to a new one? 

Laurie

Seal or nurse

I was thinking nurse, but maybe both. If you're not getting the care you need, you need to find a new care provider. You have too many frequently occurring issues to be helped by a website; you need to see an ostomy nurse and find out why they are continuing to happen. We, on this website, are only guessing at best. You deserve more than guessing.

Laurie

Hi D,

Yeah, Ol' Clubfoot has a point there. From your description, we're probably all visualizing something a bit different in our heads, and without seeing what you're dealing with, we are just guessing. We also most likely haven't asked all the right questions either. Sounds like maybe finding another ostomy nurse won't be easy? I know nothing about Canadian healthcare or how it works. But I would think with technology being what it is today, at the very least, you could do a tele-visit with an ostomy nurse a bit further away... maybe at a major teaching hospital or university. When I first got my stoma, I had skin issues and reached out to Hollister. They had me send them pics of what was going on... have you contacted any of the product manufacturers? I believe they all offer such help... but I could be talking out my frontbutt. Anybody have any other ideas how D can get some ostomy care up there in the Great White North?

Regards,

Bob

Healthcare service delivery varies from one province to the next, but even a small city like Brandon will have a hospital. There might be more than one ostomy nurse on staff, and they might run clinics on certain days - Daanders can ask her surgeon about that. And you're right - she might be able to connect by Zoom with someone in Winnipeg. At any rate, she needs to keep at it with a healthcare professional until her issues are resolved. The squeaky wheel......  And I like your idea of connecting with the product manufacturer. I found Coloplast really helpful when I was starting out - they will all be helpful, I'm sure. However, they are not clinicians. Daanders needs to see someone with some expertise.   Club foot?

Laurie

She is the only one here. I have contacted one in Winnipeg and sent her pictures months ago. She never got back to me. That's why I have no faith. I spoke to my doctor over the phone and she said she would get me a prescription. I went and paid for it. When I got home and opened it (it was nipple cream) WTF. Now you see why I have no faith. Then nipple cream is funny now. Not so much at the time.

Frustrating to say the least. You need to keep bugging your current ostomy nurse every time an issue comes up. If she can't help you, you need to insist that she refer you to someone who can. Daanders, when my surgical incision refused to close because of radiation injury, I consulted 8 doctors about it, before one told me I should consider Hyperbaric Oxygen Therapy, which is what ultimately helped it to close. If I had given up after 7 doctors, I probably would still have an open incision. I guess what I am saying is that you need to become insistent with your healthcare providers, whether they are doctors, nurses, or whatever role they have. Don't give up, and don't let them give up on you either. Their job is to help you with health issues you can't resolve on your own, so keep at it, and if they can't help you, they need to refer you to someone else. Each new person you get referred to will have different ideas; eventually, you will hear an idea that will help you. nbsp

You haven't answered my question about your flange - have you tried a convex flange? The other suggestion I would have is the new flange made by Coloplast, that is meant for people who don't have even areas around their stoma - people with hernia, surgery scars, etc. The flange is star-shaped, and meant to fit on hard-to-fit stoma. If you haven't tried it, you might want to call Coloplast and ask for a sample. I haven't tried it; my convex flange works well for me, but it would be worth a try for you.

Laurie

Nipple cream? I'm curiously interested. What exactly does one do with nipple cream? Is this a "girlie" thing... or did I miss something in the locker room?

;0)

Bob

Yes, I have. I have scars because of gallbladder surgery. I definitely am going to Google this star-shaped flange. Thank you.

Put it dried cracked nipples from breastfeeding. She is a new doctor and definitely has no clue.  

Happy dance ......... Bag change today went well ..... Skin looking better ..... Even got to put calamine on................ Start of a good day....... Thanks everyone

Hi Daanders,

Just happened to me again last night too. Noticed that I'm better off changing my way for first thing in the morning when my stoma is smaller and the wafer slides over it better. If I wait until I've been active, my stoma seems to get larger and I have to rotate the weight for back-and-forth to get it on. It seems to pick up moisture from the stoma, preventing a good seal, which allows poop to get underneath it, leading to leakage. Possibly a way for with a larger opening if you're experiencing the same thing.