This topic is about managing adhesion issues after developing a peristomal hernia and learning to change an ostomy bag independently. The person sharing their experience is dealing with an uneven abdominal surface due to the hernia, which is scheduled for repair during a reversal surgery. They are also seeking advice on how to manage these challenges on their own. Here are some helpful tips and insights shared by others:

- For better adhesion:
1. Ensure your skin is absolutely clean and completely dry. You can pat it with a towel, tissue, or Kleenex Hand Towel, and finish drying with a hair dryer on a low or cool setting.
2. Warm the wafer or barrier using a hair dryer or your body heat before and/or after applying it to improve its stickiness.
3. Press the wafer around the stoma first, then work outward. Some people find that adding a minute of gentle heat after application helps.
4. If leaks happen sooner than expected, consider shortening the wear time by a day.

- Managing an uneven surface or hernia:
1. While stoma paste can help, barrier rings like Hollister Adapt rings or thicker moldable rings often create a better, longer-lasting seal. You can combine rings with small amounts of paste for tricky creases.
2. Convex pre-cut wafers may adhere more securely over a bulge.
3. Switching from a one-piece to a two-piece system allows you to attach the wafer first and then snap on the pouch, which can be easier when visibility is limited.

- Creating a reusable template and pre-cutting:
1. Once your stoma size stabilizes, trace it on sturdy plastic or cardboard to create a template. Use this to pre-cut several wafers, so you don’t have to measure each time.
2. Some pre-cut sizes might already match your stoma, eliminating the need for cutting.

- Techniques for changing the ostomy bag on your own:
1. Find a position that gives you the clearest view and flattest abdomen, such as standing in front of a large bathroom mirror, sitting, or lying down.
2. Slightly arching your back or stretching your torso when standing can help smooth skin folds and prevent wafer wrinkles.
3. Many people remove the appliance in the shower, wash thoroughly, exit, dry, prep the skin, and then apply the new wafer. A blow dryer can speed up drying.
4. Keep disposal bags handy to contain the old pouch and wipes.
5. Use adhesive-remover wipes first, then flushable wipes or washcloths to clean any residual output.

- Product and brand references:
1. AdeptHealth pouching system
2. Hollister Adapt convex pre-cut wafers and Hollister Adapt barrier rings
3. Dial antibacterial soap for peristomal cleansing
4. Kleenex Hand Towels for final drying

These strategies can help improve adhesion over a hernia and enable you to change your pouch independently, reducing the need for assistance.