Ostomy Irritation: Seeking Advice and Support

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gairdinspreagtha

Last Monday I changed my appliance. Wednesday had a blowout. I noticed that day that my scar at the side of my ostomy looked irritated. I was a little afraid I had ripped it again. Thursday I had another blowout. This time I noticed a red ring around my ostomy. At the time I couldn't tell if the red ring would be under my barrier ring or just outside it.

The last few days I've felt itchy and ouchy right outside the barrier ring but underneath my wafer. Today I took it off to shower and I noticed the red ring was kinda raised and bumpy like a rash. It itches like a beep beep. I forgot to mention that I put skin prep on it Thursday and today. Today the wafer didn't want to stick to my skin at all, it was weird.

I cleaned it gently and called ostomy. Tomorrow they are leaving an antifungal powder and some wipe they said to use to pat the powder into my skin before laying down my barrier ring.

Does this sound right to you all? I'm enclosing a pic.

AlexT

I'm no ostomy expert but it looks to me that either 1) you're getting output under your wafer and it's sitting there until it blows out or you change it OR 2) your skin is having a reaction to your wafer/barrier wipe, etc. If I use Adapt flange extenders, my skin looks like that wherever the extender sticks to my skin for a day or two.

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gairdinspreagtha

My nurse was here a couple of hours ago and she looked and thinks I'm reacting to my wafer also. Because my barrier ring sits inside that red circle and all that is touching me where the red is... Is my wafer sticky tape.

Will the antifungal powder work on that? What is Adapt flange extenders?

AlexT

Here's a picture of the flange extenders....

eefyjig

Regarding Alex's response, I was thinking #2 (not poop, but the second option in his post!) It looks like the skin under your barrier ring is good but it's rashy just beyond the ring, under the wafer. The antifungal powder and wet wipes method will work but don't forget to end with the wipe, not the powder. So wipe, powder, wipe, powder, wipe. Otherwise, the powder will prevent your ring and bag from sticking to your skin.

 
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AlexT

I don't know if that powder will work or not. If it's a reaction to the sticky stuff on your wafer, I don't think it would. &zwj

eefyjig
Reply to AlexT

They leave a little non-itchy rash when I take them off but, boy, do they stick great.

AlexT
Reply to eefyjig

Yes, they do. I don't normally wear them but once in awhile I'll stick one on if the cloth edge starts coming off from wear and showering.

gairdinspreagtha

When I have blowouts, it's towards the lower right portion of the picture. You can't see my wound in the picture, but you can see where they sliced me up the middle towards the right. My wound is probably 4-6 inches below my sternum. Here, let me do it with a pic... Sorry, it's kinda graphic. Not completely healed yet. You can see my ostomy bag, and the wound is the more red hole. That used to be about 7 inches long and about 2 inches deep. My ostomy always blows out right there because we have to cut the adhesive on my appliance to go around the wound. It's never leaked at the other spots except when I first had it, the section to the left of my ostomy where it looks like a triangle of red.

My oncology surgeon originally cut my stoma bigger, then he sewed that section closed. When I first was trained to put my bag on, that was all stitches and I had to cover it with aquasel and place my barrier ring on top. That little piece of material that was supposed to protect that area from infection was like a crack in the dam. When they put the wound vac on me, the oncologist cut the stitches early. Big mistake because it ripped it open on the first blow out.

When I blow out, I don't really leak. It just lifts the barrier ring up by the wound, and it sits like that until I change it.

gairdinspreagtha
Reply to AlexT

Is that like a tape to hold your bag down?

gairdinspreagtha
Reply to eefyjig

Basically, you are wiping the powder off. That little bit helps?

AlexT
Reply to gairdinspreagtha

Yes, pretty much. I think it's made out of a little more skin-friendly stuff. They do hold very well.

AlexT
Reply to gairdinspreagtha

Basically, you put a little powder on, blow off any excess, and then blot the area with the barrier wipe. You kinda want to create a crust. I only use a barrier wipe if I have irritated skin, which is pretty rare now.

Marco789
Reply to AlexT

Alex, what is the purpose of the flange extenders?

AlexT
Reply to Marco789

Helps (really well) hold the edge of your wafer/bag down.

AlexT
Reply to gairdinspreagtha

So you have blowouts at the top of your bag? Looks like you may have a crease there from a scar? Which would make perfect sense. Stuff doesn't really like to stick to a scar.

eefyjig
Reply to gairdinspreagtha

You can blow the powder off and then dab the wet wipe on the powder to wet it a little so that it then dries and becomes a dry, hardened crust. It's not like clay or plastic, not that hard, just enough to cover the rashy area and protect it. I'll bet there are YouTube videos that show the crusting technique.

eefyjig
Reply to AlexT

You should really be a stoma consultant, Alex. You have a very common-sense approach and can figure out troublesome stoma issues like a detective!

AlexT
Reply to eefyjig

Well, thanks. Just trying to help the next one in line that gets the pleasure to wear such sexy accessories.

Justbreathe
Reply to gairdinspreagtha

Yes, a picture is worth a thousand words...that gap has to be troublesome- especially while sleeping or lying flat.

Seems as though some folks on this site have suggested some kind of paste to fill the gaps - wonder if that would help. Also, my stoma nurse in the hospital suggested to only put a light coat of powder followed by a barrier wipe - make sure the wipe has dried then place appliance.

gairdinspreagtha
Reply to Justbreathe

I'm at my last chemo right now. The ostomy nurse delivered a fungal powder and something called No Sting wipes. She left instructions to lightly powder and use the wipes to pat down powder into my skin.

I'm just learning to lay on my side.

AlexT
Reply to gairdinspreagtha

No-sting wipes are just wipes that won't "burn" when they touch your irritated skin.

gairdinspreagtha

I have had a catheter for four months, before the ostomy I had to learn to keep my legs flat and lay on my back. That was hard because I never slept on my back. The last month or so I've learned how to lay on my sides with the ostomy and how to move the catheter so I can lay on my sides.

Tomorrow I supposedly lose the catheter. To me that's another step to wholeness.

AlexT
Reply to gairdinspreagtha

Yep, catheters suck and getting rid of that is great. I was a stomach sleeper and going to my back, especially right after surgery, was very uncomfortable. I think now I'm in a perpetual "log roll" when I sleep....right side, back, left side, back, right side and so on. Every day, my sheets/blankets look like I have a great love life.

Ycitygrl3842
Reply to Marco789

I use Coloplast extenders. Not that often but this morning, the bottom of my wafer got pushed up with my jeans and it was right before work. So my wafer wasn't sticking at the bottom. I was like "I don't have time for this!" I put on an extender to hold it down and went to work.

IGGIE

G'day guys, I have said this before, all I use is warm water and clean tissues and I never get a leak. I hear you guys using powder and wipes and I know the wafers stick much better without all that stuff. Think about it, you're just creating a barrier for the wafer. Try good old warm water and then dry it well.

gairdinspreagtha
Reply to AlexT

LOL, I have the rolling log down. I even was getting good at moving the catheter hose in my half-asleep, maybe-asleep stage. It's gone. It's been a crazy two days between the last day of chemo and several events there to today with the catheter gone and retraining my bladder to unexpected doctor calls and appointments. I got a call from radiation for a consult. I wish someone had explained everything a bit better. That was somewhat of a shock and took me a few moments to bounce back. Of course, they are pushing back gall bladder surgery and ostomy reversal.

AlexT
Reply to gairdinspreagtha

I'm not a fan of radiation.

gairdinspreagtha
Reply to eefyjig

Just saw your response. It does try to crease there. I don't know if that will go away as the hole keeps healing or I gain weight. My lil hospital stay dropped me below 100. But they keep telling me when I'm off chemo and I get at a normal weight things will change. Skin will be soft again not dry from chemo.

To be honest, scars usually go away on me after a year if they are major. Twice I got burned on my motorcycle due to stupidity on my part. Both times it was severe burns and after a year they were gone, but if I get a cat scratch or something minor, I'm scarred for life.

I guess I'm assuming it will close more. Or if I didn't reverse it, I would probably look into irrigation.

AlexT
Reply to gairdinspreagtha

Yep, getting off the chemotherapy will definitely change things.