Coping with night-time "blow-outs" after colostomy surgery can be quite challenging, especially when you're feeling isolated and without much local support. If you're experiencing this, you're not alone, and there are practical steps you can take to manage these situations better. Here are some helpful tips and insights:

1. Connect with others: Join live support groups or use online chat rooms to talk with people who understand what you're going through.

2. Night-time routine:
- Try to wake up once or twice during the night to empty your pouch. Common times are around 1 a.m., 3 a.m., 4 a.m., and 6 a.m.
- If you sleep on your side, the pouch pressing against the bed might naturally wake you up.

3. Evening habits:
- Avoid eating after 6 p.m. and steer clear of foods that are high in fiber or cause gas, like beans, broccoli, chili, carbonated drinks, and alcohol.
- Some people find that taking a 30 mg codeine tablet at supper and bedtime helps slow bowel activity, but always consult your doctor first.

4. Choosing the right appliances:
- Consider using convex wafers or pouches for a better fit.
- If blow-outs are frequent, a larger-capacity night bag might help.
- A belt clipped to the pouch can provide extra security.
- Experiment with one-piece and two-piece systems to see which works best for you.

5. Improving adhesion:
- Use Hollister Spray Adhesive to increase wear time and prevent leaks.
- Adapt Lubricating Deodorant can help stool slide down more easily.
- Apply stoma powder, prescribed skin cream, and adhesive spray, letting it dry for 5 minutes.
- Seal edges with DuoDerm tape and apply pressure for 5-10 minutes while lying down.

6. Support garments: Light compression underwear or "magic knickers" can help control hernia bulges and keep the pouch secure.

7. Protect your bedding:
- Use washable waterproof pads on your bed.
- Place a towel over the pad and consider a plastic mattress cover for extra protection.

8. Sleeping position: Avoid sleeping on your stomach. Many find it more comfortable to sleep on their left side or back.

9. Managing odor: Drop a couple of ALTOIDS mints into the pouch after emptying to help with odor control.

10. Timing pouch changes: Avoid changing your pouch right before bed, as newly applied wafers might not hold overnight.

11. Emotional support: Remember, the learning curve is steep but temporary. Stay positive, try new products, and keep sharing your progress with others.