Good evening,
Probably a silly question but, how long did it take for you experienced osteomates to get the hang of confidently cutting and positioning your bag please?
Am 3 weeks post op so appreciate it hasn't been long, but as an experienced health care professional, and someone who wanted for a very long time to get to where I am now, I am struggling and every time I struggle it knocks my fledgling confidence.
Is it just me or is this quite common?
Many thanks x
I don't recall having many issues. Is it leaking? I did have issues with it leaking for the first several months before I got used to that. I now get them pre-cut!!!
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Do you have the template/stencil that you can put over your stoma to get the measurement? Once I found the right size, I would trace with a permanent fine point marker and do enough for a week at a time because after a week, I would re-measure. Once your stoma is at the size it will be, it gets easier.
Don't let it knock your confidence. I'm sure you're doing well for only being 3 weeks out, and there is a learning curve and everyone's body is unique. One bag change at a time. I started with lying down doing bag changes since I'd always been lying down when they showed me in the hospital, but I had trouble making sure the bottom was lined up, and I found it much easier to do the changes standing up.
Yes, I had a little leaking and my stitches were pulling but thankfully they are out now. My skin became sore but healing now and am using a barrier spray and a different style bag which is helping.
I probably just need more practice and to stop overthinking it.
Yes, practice makes perfect. I think, at three weeks especially, this is perfectly normal. I still screw up and sometimes cut a bit too much, and I'm three years in!
Terry
My bags are cut to fit. After 30 years, sometimes my placement on the stoma is off, so I take it off, cut a little more, or pull it off and recenter. My stoma is a little under 20mm/oval. My perfect placement is tight around the stoma. Take your time.
It does take time to get a handle on it and once you do it can change again, weight gain, medications that alter your weight, the stoma can change dimensions for no apparent reason but you will get better at adapting to any changes, everyone does.
It took me lots of trial and error. You are fresh out of surgery so your stoma size is going to be changing until it's fully healed.
Here are a few things I learned along the way that may help you. Have all your supplies that you will need including your cut pouch ready and within hands reach.
I learned from a stoma nurse that you don't have to go by the exact inches or millimeters on the sizing card. For instance, right now if I cut mine to 1 and 1/8 it leaves too much area so I get irritation there. One inch is too tight around the stoma so what she has me doing is cutting it between the 1 inch and the 1 and 1/8 marking and that seems to work out. Yours will be changing so you will have to measure for a while until it settles in. A hole too big can leak around the stoma and a hole too small can make a leak as well and usually under the base plate when I've cut mine too small. If you feel itchy under there like around the stoma area, like something is leaky then change it right away so you don't get irritation. Don't be afraid to try skin barriers and rings. Don't be afraid to call your stoma nurse or the pouch manufacturer for help with issues you're having. They can be very helpful and usually have videos online how to apply their products.
Make sure no residue left in the stoma area from soaps and or shampoos if you shower with your bag off. Make sure to remove any built-up adhesive. Make sure the area is totally dry before applying the pouch. What I do to position the pouch. Well, I have a clear one because I'd never get it right if there was a cover or if it was beige. I stand in front of the well-lit bathroom in front of the mirror and I try to get it so that it's fitting perfectly around the stoma without leaving too much space or more space at the bottom or top or either side before I actually lay it down to stick. It takes practice. Try to get it perfectly in the middle of that circle I cut. After getting it in place, your hand over it while pressing. The warmth will help seal it. Pouch belts help tremendously in getting a good seal also because it's tightly pressing the bag to the skin. So you could leave the pouch belt on for a few minutes. Use a small pair of pouch scissors that has blunt ends. Coloplast manufactures a pair. It's so much easier using this small pair. Less errors in cutting and easier to handle. As for mirrors, you can also position a hand mirror at your sink if you need to. Just make sure whatever room you're in is very well lit. Small grocery plastic shopping bags are great for changing as well. You can tuck one side into your pants in the front of you and leave it open so you can be throwing things in there as you're going. Always wash hands when you go to empty your bag. Hand lotions can loosen things as well as cooking oil if you were cooking and it's on your hands.
Well, I hope some of this stuff can help you out. Don't worry you will get accustomed. We have all been where you are right now.
I hope you're using a sealing washer which can take up any imperfection of your cutting. I am lucky apart from the fact that my stoma is currently changing length but not diameter, I use a pre-cut 30mm seal and a pre-cut Hollister 18183 bag and it works for me. Hold in there and let it settle down and then you're cooking with gas. Regards, IGGIE
Hello
If you are one of the lucky people that have a nice round stoma, you can make a punch out of a socket from your dad's toolbox or hubby's. Or you can buy one. You just take it to a grinder and make a nice sharp edge, then smack it with a hammer on a nice board, and you should have a nice cut with no jagged edges.
It took me a while and still have issues. My stoma is oval, like 35x25. I am still unsure how close to get, but I do wrap my barrier ring first, then put the wafer down. My stoma also puffs up.
Making a template is good, but you still need to cut outside the edge of the mark.
I tried a holster for my first 3 months, and now I am ending my first month with a Coloplast 2 pouch system, changing every 5 days.