This topic is about someone who is experiencing issues with their Coloplast one-piece ostomy appliance, specifically lifting around the stoma and frequent blowouts, four weeks after surgery. They are feeling discouraged due to these challenges and are seeking advice on how to improve their situation. Here are some helpful insights and suggestions:

1. Use as few products as possible:
- Some people find better adhesion by using only a liquid skin-prep, like 3M Cavilon, and the Coloplast wafer. Paste can sometimes act as a lubricant and cause issues.

2. Re-check stoma profile and consider convexity or surgical revision:
- A stoma that retracts to skin level can lead to leaks. Consider using hard or soft convex wafers or barrier rings to help with this. If the problem persists, discuss the possibility of a surgical revision with your healthcare provider.

3. Verify fit and cleanliness:
- Regularly measure your stoma, as even small changes can be significant.
- Clean the area with warm water and a mild, additive-free soap like Cetaphil. Avoid using baby wipes or products with oils or lotions.
- Ensure the skin is completely dry before applying any products, using a tissue blot and a low-heat hair-dryer if necessary.

4. Warm and press the wafer:
- Pre-warm the wafer under your arm or with a hair-dryer. After placing it, lie down or apply firm pressure for several minutes to ensure a good seal.

5. Consider a two-piece system:
- Some people find that a two-piece system lasts longer, allowing for 5-7 days of wear. It also allows you to change the bag without disturbing the seal and makes "burping" easier.

6. Barrier rings and shaping tips:
- For a flush stoma, you can overlap or double a barrier ring on the skin or wafer to fill any gaps. Rings are often easier to mold than paste. You can request free samples and consult with a nurse from major manufacturers.

7. Support garments:
- A fabric wrap or belt can help, but some prefer a rigid Stoma Guard that provides outward pressure while allowing output to flow through a central channel.

8. Visual aids and education:
- Watching ostomy-nurse videos and YouTube channels can provide step-by-step guidance on bag changes.
- Consider using positioning mirrors, like a commercial MediMirror or a DIY setup, to help center the wafer while lying down.

9. Leak-prevention resources:
- There are detailed presentations available online that can offer more insights into preventing leaks.

10. Mind-set and adaptation:
- Remember that leaks can happen, and it's normal to go through trial and error. Many people find that the "ick" factor fades over time, and mishaps become routine as you realize the appliance is an important part of your life.