This topic is about a 69-year-old woman who is dealing with chronic pain and management challenges after having a colostomy placed in a difficult position. The surgery was initially performed as an emergency procedure for what was thought to be a gallbladder issue but turned out to be colon cancer. The colostomy was placed very low, near the leg crease, which makes it hard to manage. She has faced several complications since the surgery, including severe pain, leakage, and a hernia. Despite seeing various doctors, her pain remains intense, and she is seeking advice on what to do next.

Here are some suggestions and insights that might help:

1. Consider exploring Medicare hospice benefits. Given her previous prognosis, she might be eligible. Hospice care can provide:
- Regular home nursing visits
- Expertise in aggressive pain management
- Support from social workers and spiritual care providers
- Flexible coverage that doesn't require her to be home-bound

2. It might be beneficial to consult a wound or ostomy specialist. They can check if raw skin is contributing to the pain and may prescribe topical agents to help with healing.

3. Increasing the frequency of appliance changes could help. Changing the appliance more often than every other week and allowing the skin to dry and air out between changes might reduce irritation.

4. Seeking peer support could be valuable. Connecting with long-term ostomates, either by phone or online, can provide emotional support and practical tips for managing her situation.