This topic is about someone who has been living with a urostomy for over seven years and is now facing challenges with their appliance due to a significant weight loss of 30 pounds and the effects of multiple sclerosis (MS). They are experiencing frequent leaks and difficulties in properly aligning their urostomy bag. After a particularly frustrating leak, they reached out to their wound-ostomy nurse for help and are looking for practical advice on how to correctly fit their appliance. They are considering switching to a two-piece system and have a Stoma Jeannie guide to assist with alignment.

Here are some helpful insights and advice for managing these challenges:

1. Weight changes can alter the shape of your abdomen and the size of your stoma, which might make your current appliance less effective. It's a good idea to have a new assessment with a wound-ostomy nurse and get your stoma re-measured.

2. Experiment with different brands or styles of urostomy systems. Some people have found success with Convatec deep-convex systems after experiencing weight changes. You can contact companies for free samples to try out different options, and Convatec is known for having responsive customer service.

3. Be aware that factors like heat, increased physical activity, and changes in body shape can affect how well your appliance adheres. You might need to adjust your products based on the season or your activity level.

4. If your weight loss was not intentional, it's important to consult a doctor to rule out any underlying health issues.

5. Consider using the Stoma Jeannie or a similar alignment guide with a two-piece system. This can help with placement, especially if MS affects your dexterity or balance.

6. Keep in close contact with your wound-ostomy nurse after trying new products. Provide feedback quickly and don't hesitate to ask for alternatives if a recommended product isn't working for you.

7. Trust your own experience with products, as skin sensitivities can vary from person to person. For example, some people may react to certain ingredients in products, even if they are generally considered safe or "natural.