This topic is about someone who has been experiencing constant abdominal pain following an ileostomy surgery in March 2024. The person has a complex medical history, including multiple surgeries and ongoing chemotherapy for leukemia, which makes their situation particularly challenging. Here are some pieces of advice and insights that might be helpful:

1. Seek additional surgical opinions:
- It's important to find a new colorectal surgeon who has experience with complex cases. The pain might be due to adhesions, a parastomal hernia, or a partial obstruction rather than the stoma itself.
- If surgery isn't an option, consider getting a referral to a pain-management specialist.

2. Use advocacy and directories to find experts:
- Check resources like the United Ostomy Associations of America (UOAA) or colorectal-cancer support sites for lists of knowledgeable physicians. Large centers in New York should have surgeons and WOC (Wound-Ostomy-Continence) nurses familiar with ostomies.

3. Address scar-tissue and adhesion pain:
- Adhesions might not show up on imaging, so consider asking for an exploratory laparoscopy or a discussion about lysis of adhesions. Pain interventions like abdominal wall blocks might also help.

4. Optimize pouch-changing techniques:
- Try sitting on a chair or couch and using a mirror to avoid bending sharply. Some people find it helpful to change while standing or leaning back slightly on the toilet for support. Experiment with different positions to find one that minimizes abdominal strain.

5. Evaluate different pouching products:
- Even if one appliance seems to work, it might be worth trying samples from other manufacturers. Different convexities or belt supports could help with hernia-related leakage.

6. Approach diet methodically:
- Follow a low-residue diet and introduce new foods one at a time, such as well-cooked, peeled vegetables or canned fruits. Chew thoroughly to test tolerance.
- Consider pancreatic enzymes if digestion issues are suspected, as medications and chemotherapy can affect food tolerance.
- Stay hydrated with electrolyte solutions to manage high-output from the ileostomy.

7. Investigate partial blockage or motility issues:
- Request a small-bowel follow-through or abdominal ultrasound when symptoms occur to rule out intermittent obstructions.

8. Seek psychological and social support:
- Chronic pain and isolation can worsen depression. Counseling, cancer-support groups, and focusing on small, positive activities like reading or brief outings can be beneficial.

9. General self-advocacy tips:
- Keep detailed logs of symptoms and food intake to share with new healthcare providers.
- Bring someone to appointments for support and to help ensure longer consultation times.
- Persistent and respectful insistence can often help secure necessary referrals.