This topic is about someone’s journey through rectal cancer, leading to a permanent colostomy, and the challenges they face with their ostomy appliance and ongoing chemotherapy. Here’s a breakdown of their experience and some helpful advice:

- In February 2010, they noticed blood in their stool and waited seven months for a colonoscopy.
- By October 2010, a very low rectal tumor was found, but a CT scan showed no spread.
- In November 2010, a biopsy confirmed cancer.
- In January 2011, they started treatment with oral Capecitabine and 28 radiation sessions to shrink the tumor.
- After surgery, an abdominoperineal resection was performed, resulting in a permanent colostomy because the tumor was too low to save the sphincter muscle. The cancer was cleared.
- Currently, they are finishing precautionary chemotherapy. However, they face issues with their appliance lifting due to varying output consistency and sweating.
- They haven’t returned to their ostomy nurse yet but are grateful for the support found in forums.

Additional details include:

- The current chemotherapy involves Oxaliplatin and Capecitabine, with Capecitabine also used during radiation.
- They use a Hollister 2-piece closed pouch with a liner, averaging a wear time of about three days, and prefer not to use drainable bags due to solid stool.
- The ostomy nurse is a three-hour trip away, and they plan to visit after chemotherapy ends.
- They recently switched from Colopaste to a protective barrier wipe and achieved a five-day wear time, wondering if sweating or different preparation is the key.
- They have avoided Imodium due to fear of constipation but are reconsidering.

Advice and insights from others include:

1. Appliance choice and wear time:
- Users with permanent colostomies report good adhesion with various products, such as Hollister and Convatec pouches.
- Barrier rings and lubricating deodorant can help reduce leaks and make emptying easier.

2. Improving flange adhesion:
- Warming the flange with a hair-dryer before application can soften the adhesive.
- Protective barrier wipes or Benzoin swabs can help with sweat-related lifting.
- Thickening the output can lessen leaks, especially when stool is loose.

3. Managing loose or frequent stool:
- Imodium A/D can firm up output and reduce leakage, but should be avoided during cramping.
- Eating small, frequent meals and gradually returning to usual foods can help normalize function post-op.

4. Radiation and perineal wound care:
- Sitz baths can soothe radiation-burned skin, and stool softeners or suppositories may offer limited relief for painful defecation before surgery.

5. Lifestyle and work:
- Regular evening irrigation can provide predictable output and easier daytime management.
- A self-made “belt” can muffle gas during meetings, and many maintain full-time jobs without disclosing their ostomy.

6. Considering colostomy vs. debilitating bowel frequency:
- Those who chose a colostomy after rectal removal often regain independence and recommend it to those struggling with urgent bathroom trips.

7. General recovery perspective:
- Surgical recovery typically takes 6–8 weeks, while gastrointestinal regulation may take six months or more.
- Appliance mishaps and food sensitivities usually lessen over time, as “time is a great healer.”