Irrigation Questions: Need Help with Technique and Travel Tips!

Ok. I've been putting it off forever and tonight tried irrigation for the first time.
Goodness...what a palaver! I thought it was supposed to make things easier...and I can see that it might once I get used to a new routine...but tonight even with the instruction sheet I found I have a lot of questions.

First, how far in is that doggone cone supposed to go? Surely not the whole way? I was very scared I was going to poke my colon..how do you know the angle? Also I had my water bag up high, maybe too high cos the water kept coming back out instead of going in! Don't know if any of the first 500cc actually got into my colon...so I filled it up again with another 500cc and then closed the sleeve thingie off so I could measure how much of it ended up in the bag instead of the colon...only half went in! Do I have to slow down the water somehow?

Then...why doesn't the darn instruction sheet warn you that 'return' is fast and almost like a fountain spurts out! Lordy this happened just as I read to close off the top with the bendy thingie.....stop laughing....I managed JUST in time!

I had two main squirts and that was it. Then I got in the shower as I felt like poop got everywhere!

The reason I finally made myself do it was I had a major blowout tonight on the way home after eating a meal out. I had just changed my flange last night, but you know I was sitting down and somehow there must have been a weak place as everything pushed under the flange and broke through under the collar. This doesn't happen to me often but goodness I hate it when it does! So there was probably not much up there.....

I am going on a trip in six weeks and I want to master this before I go...so other traveling questions are about what I need to take to be sure I have someplace to hang bag up high? I think I read somewhere that one of you uses hooks and rope....? What about water? I am going to Ukraine and have been told to only drink bottled water....so does that mean it would not be safe to irrigate with?

Lots of questions....I know you guys will help me so thanks in advance!

Terry, I started about 6 months ago and think it's great. I had a colostomy nurse take me through it the first time, so I knew some stuff I didn't get from the YouTube video that's been recommended on this site. To answer your questions:
You should move the cone around until it flows while not leaking out, and usually that means it doesn't go in all the way and usually at some angle. Mine goes about 3/4 angled to my right side and up. My water bag has a nifty flow meter on it, so when you see it spinning, you know it's flowing, and I keep my fingers around the cone to feel when it's leaking. It takes a little practice.
I have been doing a lot of traveling -- just came back from 7 weeks away -- so I was also anxious to not deal with blow-ups. The one time I had a leak was when I was in a hurry the night before, and I wasn't careful to be sure that the water wasn't leaking, so I did not get a good cleansing. I can get by with just a bandaid-like ostomy cover and not barrier + pouch, but usually go with barrier+cap just in case. I have an upcoming trip to Thailand for 7 weeks, so I am also interested in what people have to say about the irrigation water (do I have to buy 1.5 liters bottled water just for my irrigation? Wonder if I can put that one on my expense reports...)
I bought stick-on plastic hooks and used those in the first hotel, but my second hotel conveniently had a towel hook about the right height and distance from the toilet. Another tip is to always do it at the same time every day.
Let me know if you have any other questions. Take care, Carolyn

Congrats on taking that first step towards "ostomy freedom"......do not give up. The rules are...there are no rules, find what works best for your situation and stick to your routine.
A reminder: watch your fiber intake.....

Thanks Carolyn and MMSH, appreciate the input!

How much fiber should I eat? I am currently on Atkins trying to lose some weight, but of course it's salads and protein or veggies and protein most meals. I know lettuce moves through me really quickly....

I am too tired tonight to try irrigating, had a long day today...but no output! Yippee!!
I ate fish and broccoli for dinner late, about 7:30pm, so am hoping to irrigate first thing in the morning before breakfast! Hope I can stay without output overnight.

My husband says to fill the whole bag with water, to help pressure, just cut it off after 500cc goes in. Does anyone else do this?

Love the sticky cup hook idea for traveling. Hope someone will comment on the water in strange lands issue! Carolyn I am going to call my provider to see who has the bag with the flow meter....is it Convatec? I use Hollister products most of the time, but will try anything to make this work!

Thanks!

Not many irrigators here?

Now I have another question...
Do you take off your flange to irrigate?
I have done this each time...but it's dawning on me that I am using up supplies quickly and probably not helping my skin any keep putting on a new one each day...

What do you use to cover up the stoma those of you who have established a schedule? Do you change it each time?

Thanks to anyone who answers.....

Terry, no, I do not remove the flange. I wear a closed-end mini-type pouch. They make a "stoma cap" but it's nearly as large as the mini and a little more expensive (I buy my own supplies), so I can't see a large advantage to it. Watch your fiber, every ounce of fiber you put in... MUST come right back out. I don't eat much bread or veggies. Remember to take some type of nutrient supplement to make up for the change in your diet. If you are familiar with the Atkins diet, then you will remember they also suggest this. I try to keep my routine regular, that way you can do any type of activity and be confident in your lack of output. Good luck and keep us posted.

Thanks MMSH....I tried it last night with the flange in place...but just could not get the water to go in! I have a large peristomal hernia, so I hope that is not the issue.

I finally took the flange off and stood up, and that seemed to help a little bit. I closed off the irrigation bag to measure the water, and sure enough, a lot more went in the bag than went in the stoma! Finally, I had a mini return of water plus....then actually the colon emptied.

The output looked normal, not watery, so I think it was just on the way anyway. Sorry to be gross....is half the battle just getting the colon to know when to 'go'? Or should I be expecting more of an 'enema' experience?

Last night took me a whole hour. I had some samples of those mini pouches, so I put one on and went to bed. Yes, it works fine, but it's a one-piece, so it will have to come off if I try again tonight. Does anyone else out there have a large hernia? And irrigates?

Thanks to those who have helped me so far!

Terry, yes I have a medium-sized hernia. That will complicate but not prevent your irrigation.
Please remember I am not a doctor or nurse....so my opinion is just that...my opinion.

Now, I will tell you how I do it, your situation may be different...find what works for you.

I fast beforehand, at least a few hours...but I think the longer the better.

I get everything ready, including a couple of water bottles to rinse the sleeve out when I'm done.

You may have to gently, with the palm of your hand, press the hernia back into place, start the water in, I stand up.... I may put one leg up on the toilet, tilt the cone to get the best "flow"...again you will have to see what works for you. The water should go in fairly quickly...it may slow or even stop....be patient....it will start back in as it overcomes any restrictions...if not, tilt again, check the hernia...press lightly if required. I put 1.5 liters in.
When you have the water in, remove the cone quickly (as you noticed) I wait 1 full hour for the return. Take a book or laptop and don't forget the phone (cause it's gonna ring).
Now, when I'm done, I put the OLD pouch back on...go eat a light meal or snack, wait about 15 mins...this sometimes coaxes out any remaining output. Now, go take your shower and snap on a fresh bag....you should be good for 1-2 days IF you don't intake a bunch of fiber. Good luck... keep me posted, and you're welcome...glad to help. MMsh

Hi Terry, sorry for the delayed response but it sounds like you received some good advice from MMSH. My flow meter irrigation bag is Coloplast. I use two types of irrigation bags -- one you attach to your skin barrier flange. The other attaches to a flange/ring that you secure with an ostomy belt. I use the latter when I've removed my barrier and plan to go with the adhesive type stoma cap (i.e., special bandaid). I also use the flange/ring + belt over my barrier. My insurance only covers one box of five sleeves every three months and the two types are different diameters so I alternate on orders. I also just found out that my insurance no longer covers the adhesive covers. I went swimming with one of those last weekend for the first time in two years (due to other problems) and you could barely see the stoma bulge. I think I have enough to last me the summer, then I'll either try to fight the insurance or pay for them myself. I don't go bagless that often but I love having that option -- almost makes me feel normal.

I understand what you're going through with the cancer and the chemo. I had to do all that myself plus radiation when I was 45. But I got through it all, regained my stamina, had colostomy reversed, and all was good until years later when the radiation after-effects caught up with me and I had to have a non-reversible colostomy in 2010. If you have the option, don't get radiation!

Read your profile. I love kayaking too. The creek at the back of my property leads to the Hampton Creek which empties into the Chesapeake -- but haven't made it out that far. My kayaking is fairly tame and I do a lot of bird watching/photographing. In our little creek, we have Great Blue Herons, Bald Eagles, osprey, egrets...

You'll get through this and it is wonderful that you have a supportive husband to help you.

Take care, Carolyn

Oh Caro and MMSH,

Thank you so much for your comments. It is helping me to keep trying to master this!

This morning I finally had some success! I think it was the fasting overnight, doing it first thing in the morning instead of at night and one leg up in the toilet! Clearly made a difference! I managed to get most of the water in, and plenty returned back out. I had an event to go to today and nothing showed up all day! Tonight there was some output, so I need to be more regular with my meals I think, but overall I was so encouraged to have this success today.

I called and got samples of different bags and flanges last week, so now have a Hollister selection and a Convatec selection, the nurses on the phone at Convatec were super helpful!

Not brave enough yet to try those stoma caps...but they are so adorably small it will be my goal to get myself on a schedule so I can do this!

This week I may call my doc about the water issue while traveling.....just don't want any weird germs....

As for radiation...too late for me too, I had radiation and chemo for cancer in 2008, the first time I was diagnosed, so yes this colostomy is permanent. I already had a reversal like you Carolyn! We seem to have a lot in common, I also kayak for the fun of the wildlife. We are right on the Chesapeake Bay, a couple of summers ago I was lucky enough to be in the middle of a pod of dolphins while kayaking...it was spectacular!

Cheers and thanks so much for all the help so far, I love this forum!

Terry