When it comes to choosing between drainable (open-ended) and closed colostomy pouches, it can be a bit overwhelming, especially if you're new to colostomy care. Here's a breakdown of some experiences and advice that might help you decide which option suits you best.

- A newcomer to colostomy care is currently using a two-piece drainable pouch, emptying it three times a day to avoid putting too much weight on a healing abdomen. They are considering switching to closed pouches, which their insurance would cover for two per day, but they are unsure how to manage this routine.

- Three weeks post-surgery, they are immunosuppressed due to multiple autoimmune disorders and are mostly staying at home during the pandemic. Being 5 feet tall and petite, they find the standard 9-inch drainable pouch cumbersome and are trying out 7-inch mini-pouch samples.

- Emptying the drainable pouch is messy and time-consuming, involving squeezing thick output from the Velcro closure, scrubbing the exit, and using a lubricating-deodorizing additive. There is conflicting advice about rinsing the pouch, with some professionals advising against it due to leak risks, while others say it's fine.

- They are concerned about the odor and frequency of taking out the trash if using two closed bags daily. They may seek permission to use three closed bags per day due to hand arthritis.

Here are some insights and advice from others:

1. **Drainable Pouch Advantages**
- Can be emptied anywhere with a toilet, avoiding the need to carry and dispose of full bags.
- Reduces household waste and odor since fewer used bags sit in the trash.
- Useful on high-output days when two closed pouches might not be enough.

2. **Closed Pouch Considerations**
- Medicare typically covers only 60 closed pouches per month, but many users need more. Extra boxes can be purchased online.
- Shorter sealed mini pouches can solve the problem of long bags for shorter individuals.
- Eliminates splash-back and messy closures associated with drainable bags.
- Odor can be managed with lidded bathroom cans and scented trash-can liners.

3. **Carrying Spares & Travel**
- Even closed-pouch users need to carry extras, while drainable users should carry at least one spare pouch and supplies for full changes when traveling.

4. **Rinsing the Pouch**
- There is mixed guidance on rinsing. Some nurses approve it, while others advise against it due to potential seal loosening and skin irritation.

5. **Skin & Seal Maintenance**
- Excessive rinsing can dilute output, causing it to creep under the barrier and irritate the skin. Using lubricating-deodorant products can help ease emptying and control odor.

6. **Cost & Insurance Tips**
- Some drainable pouches are noted as economical for self-pay users. Secondary insurance or physician letters may help in appealing for additional supplies beyond Medicare limits.

7. **Comfort & Concealment**
- High-waisted clothing can help support and hide longer drainable pouches.

8. **General Encouragement**
- Trying free samples from different manufacturers can help you compare sizes, closures, and comfort before making a decision. Your choice will depend on factors like output consistency, lifestyle, height, hand dexterity, and personal preference for emptying versus disposing of bags.