Urostomy Bag, Ileal Conduit

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Bab

I need to know how I can put my urostomy bag on by myself without the help of my husband. I am very short and have gained weight, so we stand in the bathroom with a mirror. As I am applying gauze to the stoma so the urine (which leaks out as soon as I take the patch off to replace) will stop flowing (we clean at this time also), my husband applies the cream that goes around the stoma, and as I am still holding the gauze on, he then applies the bag. We need 3-4 hands, and I feel I should be doing this by myself because sometimes he is not here and I have to wait till he gets home. The mirror is used so I can see what we are doing as I do have a layer of fat in my stomach that gets in the way. If there is anyone that can help me figure out how to do this by myself, I will greatly appreciate this. I need someone who does this themselves and maybe has some new ideas. Please don't tell me to contact a nurse because they have not been that helpful. Thank you.

Past Member
Hi Barbara!
If you really-really don't want to hear from the nurse - don't read it - I am an ostomy nurse, but I don't think it would hurt to hear another tip.
Smallest tampon, like Ob, can be inserted into urostomy to give you enough time to change pouch without moisture, but a 2-piece appliance needs to be used.
Let me know if you need details of the procedure.
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lampelady
Hi Bab,
First of all, try to change right after you wake up in the morning, before drinking a lot of coffee and before eating any food. You should have a minute or two between squirts, and it's easier. Get everything you need ready before you start. Cut your wafer or shape it or do whatever you need to do. I use a two-piece system. When I'm ready to start, I pull the bag and wafer off, use adhesive remover on my skin, then jump right into the shower. I clean around the stoma first and take a normal shower. I do not use cream rinse on my hair the day I change and I use Ivory soap to wash because there is no residue that will keep your glue from sticking. Dry off really well when you get out. Maybe even use a hairdryer on low heat on the skin around your stoma. I use a dry washcloth under my stoma pressed against my belly while I put skin prep around the top and sides. (If you don't use Convatec, don't use a skin prep with Hollister. The skin prep not only protects my skin from the adhesive but is kind of an adhesive itself.) I wait until the stoma squirts twice (because you have two kidneys) then I put the skin prep around the underneath side. I have a magnifying mirror sitting on the edge of the countertop that I can see my stoma up close. I slap the glue wafer on between squirts. If urine gets the glue wafer wet, I throw it away and start over. Sometimes while I'm waiting for the skin prep to dry and the best time to apply the wafer, I bend over and let the urine free fall into the washcloth or onto a towel placed on the floor instead of holding the washcloth against my stomach. I apply the wafer while I'm standing up. I tried sticking it on while I was bent over. It's not hard to do, but it didn't stay on as long when I did it that way. Hope this helps. They say it's different for everyone, so I say experiment. Good luck
Lin
lampelady

I would like to hear from the urostomy nurse about sticking a tampon into the urostomy to keep the urine from flowing. The hole in my stoma doesn't look big enough to put a Q-tip in. It sounds gross and scary, but if it works I want to know about it. Timing is such a hassle and it gives me so much anxiety I almost feel sick afterwards. Anything you can tell me would be greatly appreciated.

vulcanBMk2
Oh dear, after hearing your problems, I feel a bit of a fraud! It takes me about 1 minute to change my bag. I get my kit ready in the bathroom: a disposable doggy bag, 3 sheets of paper kitchen towel, and a new bag. Having already drained the old bag down the toilet, I put the bung in the drain tube of the new one (I use a Welland one-piece, don't like bags with hard plastic taps). I then lift up my shirt, drop my pants, and pop the new bag under my arm to warm up. Then I peel the old bag off and pop it in the bag which I have hanging on the basin tap. I damp down a piece of kitchen towel, gently wipe the stoma and surrounding tummy. I then wipe with a clean sheet of dry towel and take the new bag from under my arm. At this point, I place my 3rd sheet of kitchen towel right over the stoma and surrounding tummy to absorb any moisture and catch any urine dribble that may spurt out. Off with the new bag wafer backing paper and remove the sheet of towel. I then bend the bag over slightly, starting at the bottom, smooth the bag upwards, and press it firmly to my tummy. Job done - no problems! I don't use paste, wipes, fillers, or reinforcing flanges.
I change my bag about once every 48 hours and am not really bothered if it's morning, noon, or evening. I shower 2 or 3 times a week and am not bothered if I shower with the bag on or off. I shave my tummy hair once a week to aid adhesion. I also change my night drain bag once a week. After draining, I squirt down a small amount of Zoflora diluted floral disinfectant to keep it sweet.

I'm sorry you are having problems, but I found that having a set routine helps. I think I have it down to a fine art.
 
Living with Your Ostomy | Hollister
lampelady

Oh dear, I would hate to change my bag and wafer every 48 hours. I don't think I would have any skin left. When I was released from the hospital, they told me I should shoot for 5 days. In the beginning, before I experimented with different kinds of wafer adhesive seals, I was having a leak failure in 2, 3, or 4 days, never knowing when I would suddenly be wet, at the dinner table, in bed. Now I never have a leak and I change every 5 days, unless I'm going swimming or hot tubbing, or I sweat it off, then I might change in 48 hours. I'm glad your change is easy though. I laughed when I read you warm it up under your arm. I use a moldable adhesive and it has a 1/2 inch hole that I stretch out to 3/4 inch. I don't allow for any gap. The adhesive is pliable and my fingers are small enough that I can get them between the stoma and the ring that the bag attaches to, so I press all the way around to get a good seal. Anyway, it stays stuck until I decide to take it off, that's the main thing.
Lin

Catesmom

I have to change my urostomy pouch every 2 days. It leaks because I have an inverted stoma with a little "crevice" and the urine eats through the Eakin seal and barrier. But changing it is never a problem. I change my pouch first thing in the morning after my shower. I get my supplies ready beforehand. My wafer/pouch, and I have on hand a facecloth to clean my stoma, and some clean paper towel to absorb any urine (on the tampon idea). When I do this, I find it much easier for me to do it lying flat, either on my bed or the couch, and have my supplies right behind me. I never have any problems.

Bab

It's not that I don't want to hear from a nurse, but I had some experiences with the home nurses that had to look in a book in order to help me. Please give me whatever suggestions you might have. Thank you.

SheliaBaby

Everyone is different....but this is my "method".

My "bags" are one piece and have the karaya seal.....you do not have to use paste. I do use an Eakins cohesive seal because I do not have a washboard tummy....despite my best efforts of course )).

I also have tried the hairdryer trick on occasion.....on cool. But I also have used the powder....I think it is Karaya Powder. I take a bath/shower, remove the bag before or sometimes during, I only use the adhesive remover to take off the excess at first.....but then let my bath take off the adhesive wipe residue. I think that sometimes that contributes to it not sticking well if that is a problem.

When I am out of the tub, I dry the area well.....but gently. Air dry seems to be best for me.
I do the same wash rag trick many of you seem to use. I have my bag ready to go usually.
It has backing that peels off the plate. I slap the cohesive seal on and then slap it on me.
That's a "gentle" slap......I mean it is quick.

I always wear a belt.....for security. I have had this thing for 40 years! LOL Since I was 5 years old. I had an option several years back of some type of reversal.....and would have had to do catheterization. I preferred the urostomy.

If your tummy is an issue.....would laying down flat help you in any way? What about reclining in the bathtub? I am pretty sure they even make some type of bath pillow/wedge.
If there were some "leakage" you would be in the tub......it might be something to try.

I also think you might try the "stick on" type of appliances. I used to use the paste. It is very difficult to put it on quick enough.....to "beat" the ....well....you know what I mean.

Lots of the companies are very nice about giving you samples. If you wanted to try some, you might ask........Good Luck! SheliaBaby

gutenberg
HI All, after reading about urostomys' I will have to think twice before I start bitching about having an ileostomy and the troubles I have run into, in comparison I think I'm way the hell better off, you all have my sympathy, Ed
SheliaBaby
Hahahaha.....well Ed, I was thinking the same thing when I read some of your posts! Great way to look at things.....guess we all need to "quit bitchin' about how bad we have it" and remember to be grateful for the "good things".

Shelia

Baby
topcat2

It just takes practice, dear. Trial and error (mostly error) is how we learn. Have him by your side for support, and you will learn.

theiko

I would suggest that you wait at least 2 hours without liquids and with this type of planning you should have very little leaking as you change your pouch.

theiko

You do not mention what you use to clean around the stoma. I find a solution of 1/2 warm water and clear white vinegar cleaned with a 4x4 or 6x6 cotton wipe will give you a good result.

Rusty

This may or may not help you, but I glued an oval mirror to the inside of my bathroom door, at the correct height to enable me to see my stoma, freeing up one hand anyway. The mirror is covered by a bathrobe hanging on a hook when not needed, and out of sight to others.

I also use a clothes peg lamp clipped to my towel rack nearby to light up my work area when needed, then put away till next week.

Good luck!

rickb

I have had an ileal conduit for 58 years. I use a 2-piece system by Convatec. I replace my bag every 4 to 5 days. I used to replace my appliance standing, but now I do mine lying on my back in bed. I find it much easier. I change it whenever needed, morning, noon, or night. I remove the old faceplate, take my shower, dry off, get a fresh dry towel, lay down in bed with my head slightly elevated. This lets the stoma fall back inside some, (I have an extreme outie). I use benzoin for a skin barrier. It seems to work better than anything else I have tried. I have two distinct creases from scarring that I use a piece of Cohesive Seal to fill, then apply the wafer. I have built a 3-piece system, one piece inside the pouch, two on the outside that help hold the whole thing together and keep a good seal. The two scar creases make keeping a seal sometimes difficult. Without the additional pieces I built, I was seeing a leak in 4 to 5 hours. Hope this helps.

Rick

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