Unique placement of ileostomy: How to empty pouches effectively?

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socalileo
Sep 13, 2011 4:51 pm

I have an issue with emptying my pouch at home. I have to stand and straddle the toilet bowl to empty my pouch. This is not doing my back any good.
When I am out in a public bathroom, I can sit far enough back on the toilet seat that I can empty while sitting down. I can't do that at home as the toilet tank gets in the way.
My ileostomy is located in an odd place (I have been told). It is located slightly to the right and above my belly button - in my ribcage area, as opposed to my lower abdomen. So, my pouch does not hang down far enough that I can just open my legs while sitting on the toilet and empty.
How do other ileostomates empty their pouches?
I am open to any suggestions. I know there has to be someone out there with a similar issue.
Thank you in advance for your help.
Socalileo

Xerxes
Sep 13, 2011 5:59 pm

It does sound like an unconventional spot for your stoma to be placed. I can see your dilemma. I have a more 'traditional' stoma position, but what I have done at home on occasion, especially if I am using the shorter appliance, is to kneel in front of the bowl and then empty. This is most convenient considering what would happen if I emptied standing up. I am sure this would work for you and would not be as stressful on your back.



X_
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gutenberg
Sep 13, 2011 6:01 pm
socalileo
Sep 13, 2011 7:23 pm
Hi X,
Thanks for the suggestion of kneeling. I tried it and it is a better position for my back health. My knees, however, need a softer landing, so to speak. I will have to work on getting down on my knees and up from my knees in a back-friendly way and get some kind of cushion for my knees. After I get all of that figured out, it looks like this is going to work out for me much better. Thanks again!
socalileo
Sep 13, 2011 7:29 pm
Hi Ed,
Yes, I had many issues with my surgeon and would definitely not recommend him to anyone. Nevertheless, things are what they are and I have to do what I can to make things work. I did call my supplier (Hollister) and I have the longest pouch available from them which is 12 inches. I think I remember my ostomy nurse ordering the longer pouch for me for some reason, probably the one you are thinking of.
I have had Hollister since my surgery and have had good results. Only one accident and that was due to a faulty flange (threw that box right out!). And, I get 5-6 days wear. I don't know if anyone else has longer pouches but I have a call in to my ostomy nurse to see if she has any suggestions as well.
Thanks for your input!
Socalileo
 
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beatrice
Sep 13, 2011 10:47 pm

With the location of your stoma ... the first thing I thought about was kneeling too.

You know those inexpensive foam pads that you get at dollar stores/etc for using to kneel on when gardening? Get a couple of those and keep them tucked by the side of the toilet.

Xerxes
Sep 14, 2011 3:33 am
Hi,

I have, on occasion, used the long pouches by Hollister. I think that they are designed for high output and are especially good for an ileostomy when sleeping. I usually use Convatec, however. Although they make a high output pouch, it is not as long as the Hollister one. I might be wrong, but I think Hollister has a 16-inch pouch.

X_
djm_2010
Sep 14, 2011 10:20 am

Hello, I usually sit on a stool when I empty my bag. My ostomy is on my left side, so I place my stool at the side where my stoma is and sit sideways. It's very easy to empty your stool this way at home, but when I go malling, I empty it standing up. I really don't have a choice, he he he. It's easier to do it sitting down! Take care!

Bill
Sep 14, 2011 5:26 pm
Hello

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socalileo



I don't have this particular problem but as you say that you are open to suggestions here is one that I tried earlier and it  crossed my mind that if I were in your position it would be something that I would have a go at just to see if it worked.



The plastic irrigation tubes are plenty long enough to go right into the toilet (Coloplast has a sticky flange and is longer and wider than Hollister which is a non-stick belt system) if the Coloplast one were to be cut across the flange it would stick underneath whatever bag you are using at present and the waste would simply flow into the longer tube.



I had a bit of trouble with an adverse reaction to the adhesive but I still persevered with the Colplast tubing by cutting my bag away, leaving the flange on and sticking the irrigation tube over the old flange. It worked fine but now I've found some protective spray that has resolved the irritation problem.



That's my 'simplest potential solution'. However, if this was my own problem that I had to deal with on a regular basis, I would be looking  to make an adaptation to my toilet so that I could 'do the job at my own convenience'.



Some years ago I had already thought of a urinal for men to urinate from the  proper standing height into a tube-like device to avoid 'spillage' This device would be semi-permanent and flushable just like any other toilet. There seems to me no good reason why such a device should not be availbale for feaces as well as urine.



These types of problems should be simple for any plumber or DIY person to overcome. Toilets were only made to look like they are today because most people defeacated from their backsides. Surely we now have enough ostomates to be demanding different style toilets for the home and for disabled toilet facilities.



It would not surprise me if such a device had not already been invented in the great inventive victorian era. A little research into old patent applications would probably give you an answer to this problem and by now any patents would have expired!


If you cannot find a solution I would be happy to do some experimenting and make further suggestions if I can find a reasonable, practical solution.  



Have a go at the 'simple-solution' and if that does not work for you - Just let me know!



Best wishes in overcoming your problem  



Bill
socalileo
Sep 15, 2011 1:51 am

Great idea! Foam pads that are made for kneeling. Who knew? Thanks, Beatrice.

socalileo
Sep 15, 2011 1:56 am

You are correct X! You reminded me that I was given the longer (bigger) pouches because I had a high output that was very liquidy for months and months. I did not contact Hollister directly but contacted my supplier. I will contact Hollister and ask about the 16" pouch.

socalileo
Sep 15, 2011 2:14 am
Wow, Bill! You have lots of good suggestions! It took me a few reads to figure out what you were talking about with the irrigation tube, but my brain finally kicked in. That would probably do the trick. I'll have to talk to my ostomy nurse about obtaining irrigation tubes.
You also gave me a great idea with the DIY suggestion. I have a cousin who is very handy. I'm going to discuss the situation with him and see if we can't come up with some kind of adaptation to my bathroom/toilet area that would help me. The stool idea was a good one, but my bathroom is really not big enough for a stool. But, I bet he could make me one that was narrower or something that would fit. Or, he may come up with some kind of device like you were talking about in the urinals. Something that would be the right height and just kind of "funnel" down into the toilet. You got my brain working, Bill. Thanks!
Bill
Sep 15, 2011 7:12 am
Hello again,

Sorry about the long-winded explanation. A picture is worth a thousand words they say - and with practical gadgets they're probably right.

It seems like an easily  resolvable problem and I was contemplating it last night ( I think better in the sleepy-twilight moments between going to sleep and waking up)

These comments might be useful to your DIY plumber!

Looking at my own bathroom it occured to me that the obvious solution would be to use the sink. The problem with that (apart from my wife's possible objections)  is that the sink hole has a metal filter to stop solids going down. My bidet on the other hand has a removable plug wich has the filter attached - so it could be removed easily. The bidet type fitting could easily be transferred to the sink unit.

The second problem would be that sinks have an 'S@ bend to stop the smell coming back from the sewer. This is also easily resolved by changing it for a device called a 'HepvO' valve.

(Made by Hepworthplumbing) which is a self-sealing waste valve. On this inside it's a bit like a large blow-up balloon mouthpiece where the stuff can go through but it seals itself immediately afterwards.  I fitted these to my bath and sink some time ago and they work perfectly well.

I hope you find this helpful

Bill
Primeboy
Sep 15, 2011 2:54 pm

Good question! Take a pair of old socks rolled into a ball and leave it on the
floor. You just need to kneel on one knee. (If you push yourself up from the toilet afterwards, however, be sure to use both hands on each side of the bowl otherwise you will crack the seal at the base of the toilet and cause a leak.) When away from home, stand over the toilet but put extra toilet paper in just to reduce splashing.

gutenberg
Sep 15, 2011 6:16 pm
Hi Socalileo, the more i read these helpful replies it just dawned on me, For many years I've had spinal problems and also my knees are a bother when I have to kneel down and when I read Beatrice's comments i remembered I have about four of those Dollar Store pads and usually can get away with two at a time and at that price if you just bought two and see how they work and use them right away until you come up with a better solution and as primeboy said remember to use two hands, one on each side of the bowl which can save you a lot of grief in the future. Of course you can keep adding these pads as long as they don't take you too high from the toilet bowl as in this case its add as you go and find the right height and save your back and knees and all for a buck a piece, hard to go wrong, Ed
gutenberg
Sep 15, 2011 8:51 pm
Hi again Socalileo just looking at the adds on the bottom of the forum posts and came across this neat invention that I'm sure you would find interesting, although It may not be on the market right now but with some of the ideas already posted you will have time to ponder this new idea and as a matter of fact as more news comes out I can see myself getting one, Ed

http://www.opodd.com/OPODD/News.html

Addendum: maybe it would be a good idea to click on purchase
first, it kinda blew my socks off, Ed
reddog
Sep 16, 2011 12:53 am
Here is how I empty my ileostomy pouch which is in line with my belly button and off to the right. I use a urine measurement container which is 6 inches high and 4 1/2 inches wide, triangular in shape, that I received when I left the hospital.
I put the container on the bathroom sink countertop and empty the contents of the pouch into it while I am standing over it.

I then fill the container with hot water from the sink faucet up to 3/4 full, making sure the contents don't spill into the sink. Then you just empty the contents into the toilet. I then put the empty container on top of the toilet tank until I need it again.

Since I have to empty every 2 hours, this system is easy and quick, no back or knee issues and no cushions. Piece of cake.

Note, you can use any similar plastic container which holds the contents of your pouch. I have to empty 8 to 10 times a day. What a bummer.
mooza
Sep 16, 2011 3:19 am

Hey yeah, I was thinking about this as well. Mine's on the left, but really no bother. Could you empty it out to the side of the bowl? HMMMM, crappy spot haha. Sorry, um yeah, like someone said, the irrigation sleeves. Could you get some freebies from one or all the companies? I would certainly give that a go. Oh yeah, even if we get them free, but I did want to change my company a few times, so I got samples. And I liked the free toiletry bags. Goes I'm a lush hahahaha. Then they send in white envelopes hahahah. Yes, even though! I would try that. Now I will read every answer. xxx Mooza ..Australia xxxxxxxxx Cheers.

socalileo
Sep 18, 2011 9:25 pm

Thanks again, Bill,
I will give him this information. I don't have a bidet. I don't think they are as prevalent in the states. However, some people do have them so I'm sure the parts are available at plumbing supply places. I know about the S-shaped trap under the sink and can see how that could be a potential problem. I don't follow your solution, but I'm sure my cousin will and that's all that matters.
Socalileo

socalileo
Sep 18, 2011 9:28 pm

Thank you, Primeboy, for the advice about the toilet bowl and using it properly as a help to get up and not cause it to leak at the bottom seal. Good advice. Wouldn't have thought of that.

socalileo
Sep 18, 2011 9:33 pm

Thanks, Ed. I went to a nearby dollar store but of course, that one didn't have what I want. While I am out and about this week, I will pass lots of dollar-type stores. I'm sure to find those foam pads. That does seem to be a good short-term solution. For now, I'm using balled up socks which aren't as comfortable as foam, but the suggestion sure helped!

socalileo
Sep 18, 2011 9:39 pm
Hi Reddog,
You must be a lot taller than I am because sitting that container on the sink counter puts the mouth of the container above my stoma! But, I get the concept. A small table would do the same thing if I got it the right height.
I'm sorry you have to empty so often. My "normal" is 6-7 times a day but I'm not normal very often. I have Crohn's disease as well and when that decides to flare I am emptying up to 20 times a day so I empathize with you.
Thanks for the idea.
Socalileo
socalileo
Sep 18, 2011 9:42 pm
Hi Mooza,
No room for me to get to the side of the bowl to empty from the side, but thanks for the idea of getting samples from companies.
socalileo
Sep 18, 2011 10:03 pm

Hi again Ed,
Wow! I just looked at the website for the OPODD. It's a little pricey for me! It is interesting and could be useful, but the price needs to come down a lot!
Thanks for sharing
Socalileo

gutenberg
Sep 19, 2011 12:01 am
Hi Socalileo, I agree with you about the price, but if you knew someone who's always tinkering with something I'd guess they could come up with something just by looking at the pictures and think of a way to come close enough to duplicating or close enough to do the job, anyway good luck and I hope you find a way to make your life a bit less stressful, Ed
Primeboy
Sep 19, 2011 1:39 am

I might be missing something here, but I am not sure why a $149 device is necessary when we have two hands and ten fingers. If people are infatuated with this new technology, however, but want to save their money, I suggest that they get a pair of chopsticks and use their imagination.

Xerxes
Sep 19, 2011 5:41 pm

PB,

You are always the pragmatist, my friend.

Past Member
Sep 19, 2011 6:41 pm

You need an elongated toilet. Talk to your plumber. Kohler makes one that leaves more space in front of you when you are seated.

Lalu
Sep 19, 2011 8:02 pm
Hi, SoCalileo.

Back when I first came home after surgery, I decided to multi-task when emptying the pouch, by lowering myself with my knees and strengthening my thigh muscles. I usually don't remember to do that, so I have very flabby thighs and a bad back. I have alot of obsessive/compulsive tendencies, not at all a good fit with an ostomy no matter what products are used. I don't like the pouches with clips or velcro, as I usually don't feel like I can get the ends clean enough when I'm finished. I'm also not crazy about taking medications like Lomotil and really dislike dealing with the sludge-like consistency of output that occurs from using these meds. My solution will probably not be used by very many people, but it works for me. I use high output pouches, with bottom openings very much like urostomy openings except they're wider. Hollister and Coloplast both make these pouches and I'm pretty sure Convatec does also. Since I don't take medications usually used for diarrhea, my output is usually very liquid, but it depends on what I've eaten. When the output is liquid, especially after drinking alot of water, soda or clear soup, it takes a second to empty out and the pouch itself is alot cleaner. Whatever form the output is, it takes one quick wipe to clean the closure end of the pouch. I think someone mentioned emptying the pouch into a different vessel. This type of pouch lends itself very well to this purpose. Since it's mostly liquid output, the larger pouch size helps alot. The only real issue I've had is with certain foods that would normally be digested in the colon - mushrooms, olives, cantalope, water chestnuts, for example - any one of these items can clog up the opening since compared to the other types of pouches, this opening is relatively small. I found these foods need to be chewed for about three days per mouthful to really break them down, or when they cause a clog, they either have to be broken up through the pouch, or pushed through the opening. Pushing them through will usually decrease the useful life of the pouch since the pressure it causes eventually may cause tiny leaks to form on either side of the opening. I've been using these pouches in this way almost exclusively. I need to get creative in the summer to wear shorts, but I just feel cleaner and more secure like this.

Primeboy, once again you hit the nail on the head - I checked out those $149 chopsticks. They've GOT to be kidding!
gutenberg
Sep 19, 2011 9:06 pm
Hi again Socalileo, well you sure got a lot of input from your question, one thing came to mind after reading your answer about putting a vessel on top of the sink which would be too high, which got me to thinking: assuming you have a cabinet type sink you could have a leaf type piece hinged, and at the height you would require, and after you finish emptying the shelf would drop down flat against the cabinet and out of sight, just trying to be helpful, Ed

PS: as much as I like Primeboys' chopstick Idea, I think you would need three hands!!!
BUT the two hands and ten fingers works great for me, and it only takes once
to overshhot the end of the pouch and you learn realy fast where to stop!!!!