Update time. So I changed my barrier this morning, but before I did I sat down and re-read that peristomal skin article I gave a link to. This time paying attention to the order of things. After re-reading everything.........I might just be overthinking this whole thing. Not that I've ever done THAT before.
So in summary the article lists the most common causes of peristomal skin irritation, and they are;
So ok.....let me walk thru those. The first one I've always pretty much skipped over, looking for a better reason than that. And that might have been my undoing. But I'll come back to that.
Irritant Dermatitus is primarily caused by leakage. Simple enough......I'm not having any leaks....and believe me I check. Also, when I do have a leak, my skin in that area turns a deep dark red......not pink or light red. So this ain't my poison.
Infectious Dermatitus is primarily where I focused my efforts previously. This includes fungal infections and foliculitus Never saw an issue with the hair follicles, but did get some relief a few months back by usin an anti-fungal.......so this one is in play.
Allergic Reactions. This is also where I thought my problem might be coming from. The way the redness just peeked past the barrier seemed to indicate it was caused by the bandage material. So this one is in play.
Pyoderma Gangrenosum. From what I see in pics it doesn't appear this is my problem. But this is serious shit, and if it spreads to my bowel I'd be in some serious deep crap. So rather than trust my gut I'm engaging my Gastro and Derm Team to make sure I can rule this one out. Stay tuned for that.
And that's pretty much it. So I've been treating it like it's either an infection or an allergy......and nothing is working. So what does that tell me........well, maybe it's neither of those. I won't say for sure it's not......and may continue treating like it is......but sometimes if it quacks like a duck, and walks like a duck.....it could be a goose.
Which brings me back to the very first topic, which I continue to overlook. Mechanical Trauma. So I thought about that for second. My skin is pretty tough, but having adesive applied and pulled off, being shaved, and then covered tightly every other day might just be taking its toll. I mean it DOES do better when I uncover parts and just let it breathe in between changes. So could it be I've simply been overlooking the obvious? Well, maybe I guess.
I've got a few days before my Gastro gets back from vacay, and I don't see the Derm Docs for another week or two.......so I got some time to think about it. Today I put some ice on the whole area, which felt great, and was about to apply a protectant sheet.....but decided against it. I've got to sort out the whole how to deal with the extra thickness and how far from the stoma I should cut the hole (so my ring still functions properly without being too tall)....and standing over the skin with the clock ticking isn't the place for that. So I dried everything real good and went back to the Marathon protectant....as I had some goodprogress with it. Maybe I just didn't keep at it long enough. So.......for those concerned........I'm doing ok. As long as SOMETHING still sticks to me......I'm good. So the saga continues.......and with your help we'll eventually crack this tough nut. And hopefully someone else might find the info useful.
Oh, I should note.....the other reason I'm not leaning toward that wonderful Pyoderma Gangrenosum as the culprit is because having that this long without treating it should have landed me in really, really big trouble by now........and I'm not even seeing the slightest of ulcerations, a hallmark of this nasty crap. But like I said........I'll have it checked anyway, as it's too serious to ignore.
Everyone have a fantastic day!!