Aside from the fact I don't like my bag, after three years of having it, it dealt with everything pretty well. I had figured out how to make a wafer last for a week and a half with no leaks. And when it itched, I figured out how to minimize it. .....and then somehow I got a small pressure ulcer on 05/03/15 about the size of half my pinky nail. And it has grown to be the size of my stoma (quarter size) in three weeks. And it is right next to my stoma. UGH!!!! It hurts like hell, and I go through wafers like one every two and a half to three days. Tomorrow I have been referred to a wound care doctor by my PCP, so we will see. As of right now, I have to put butt paste and/or this other prescribed cream, silver something. And I have to use a Brava protective sheet under my wafer. (Warning: if you don't have adhesive remover, use coconut oil.) Well, that's all I have for now, except this freaking SUCKS!!! THANK YOU for reading my complaint. If you have any questions...post them. I've never written a blog before, so I don't know if I did it right or not, or if it made any sense.
Chances are, the sore adjacent to your stoma isn't a pressure sore, per se. Pressure sores are caused by pressure, and almost always develop over a bony prominence, of which there are few over the abdomen. From your post, it sounds like you've had some leakage (itchiness almost always equals leakage). After figuring out the primary cause of the sore (pressure vs. enzymes/bacteria from leakage vs. moisture build-up not related to leakage vs. trauma from stripping or an ill-fitting wafer), I'm betting on moisture, either from leaks or from sweating. Do you have tell-tale signs of candidiasis—a rash consisting of little pinpoint dots? Stop using butt paste and switch to anti-fungal powder (Desenex foot powder is inexpensive and works well). Apply a very thin layer, blowing off the excess. Crusting is a technique of using alternate layers of anti-fungal powder, patting over the powder with a no-sting skin prep pad—two layers of each. I'm sure you don't need to be told twice to make sure your skin prep is no sting! You can apply the wafer directly over the crusting as soon as it's dried. Slowly build up your wafer wearing time back to a week. You're really pressing your luck going longer than a week between wafer changes. Good luck!
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Well, thank you for your comment and advice... much appreciated. I went to the wound care doctor today. They looked at it and the pictures I took as the ulcer progressed. They gave me a patch that feels like felt but has silver in it and melts when my wound weeps. They were perplexed by it. They thought it unusual that an ulcer would appear under the wafer so close to the stoma. So, they are keeping an eye on it as I have to go back weekly. The possibility of it being something else... well, it could be possible. I guess I am rather lucky that this is the only real issue other than the leakage and itching that I overcame for the most part, for the past three years. I have had surgery and have not seen a doctor for three years and have not been on any meds. Well, maybe luck had nothing to do with it. God is on my side.
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Hey hey! I spent close to six months dealing with what I thought were pressure ulcers from using a convex wafer to skin issues caused by leakage. Just like you, it was an ulcer right next to the stoma that hurt like hell and continued to increase in size. Finally, one weekend it increased in size and pain intensity to the point that I wasn't able to eat or drink and checked into the ER. A savvy WCON immediately recognized it as pyoderma gangrenosum. It's a fairly uncommon skin condition associated with autoimmune disorders, but it sounds exactly like what you are dealing with. Check out some pictures and see if the look fits!
My Ostomy Journey: Kimberly | Hollister
So, the update on what I thought was a pressure ulcer: My PCP referred me to a wound care doctor. He has me putting on this white felt material that has silver in it. It hasn't really gotten better, but it hasn't gotten worse either. He took a biopsy, and he said this week it was diagnosed with Crohn's of the skin. Really? What the hell is that? Yeah, because he didn't know what it was.
I had a teaching friend who ended up in the hospital a number of times with Crohn's -- I did not know much about it, but she said it can appear in any organ, and the skin is your largest organ. She was so pleased to be pain-free after getting the ileostomy. She had so much scar tissue from prior surgeries that she has an area that will never heal. She is still going strong after at least 15 years since the ileostomy, which she feels was the first thing they should have done - not the last.
Do you wear a hernia belt? I had some sores around my stoma and the doctor thought it was PG. I found a great WOCN nurse and she discovered that they are pressure sores from my hernia belt. I wore my hernia belt 24/7, and now, a week later with no belt, the sores are healing.
I do not wear one. I don't know how I got this thing. My doctor wants to do some tests on me. He feels that I have an infection... after three years of no meds! I was on no meds after surgery and now I have to get back on them. He wants me on Humira. Not looking forward to it! When the test came back, my wound care doctor said it came back stating Crohn's of the skin. I don't know what to think of it. I am just tired of all of this!
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I had the same thing happen to me last year. The ulcer lasted about three months, and talk about pain, I didn't get much sleep for a while. Hopefully, you won't have any nerve damage, but talk to your nurse about that. Mine caused some nerve damage, and the pain lasted a long time. Most of the pain from mine is gone now, but it takes a while to go away. Hope it heals up quickly.