This topic is about managing public accidents when living with an ileostomy, which can be a challenging experience. The person sharing their story had an emergency ileostomy due to severe gastrointestinal bleeding and has been navigating life without professional follow-up care. They face frequent accidents and are seeking advice on how to handle these situations with confidence and dignity. Here are some helpful tips and insights shared by others who have been in similar situations:

1. Be prepared every time you leave home:
- Carry a small "go-bag" with essentials like baby wipes, a spare pouch/flange, closure, disposal bag, paper towels or gauze, and even spare underwear or sweatpants.
- Some people keep a full change kit in a shopping bag or wear a Depend for extra security when out or at work.

2. Switch to appliances that minimize known failure points:
- Consider using Velcro or snap closures instead of clips, as many accidents occur when clips pop open.
- Try a sturdier one-piece pouch, such as Hollister 8246 "Premium" or other high-seal systems.
- Brands like Hollister, ConvaTec, Coloplast, Nu-Hope, Cymed, and Marlen offer free samples upon request.

3. Reinforce or protect the seal:
- Sure Seal Rings can be placed over the flange to contain a leak long enough to reach a bathroom.
- Gorilla Tape can be used to secure lifting edges or cover tiny punctures until a change is possible.

4. Control or eliminate seed/skin punctures:
- Peel or core tomatoes, scoop out seeds, choose seedless varieties, or satisfy cravings with tomato/V8 juice.
- Avoid or limit other indigestible skins/seeds like grapes, apples, potato skins, winter-squash rind, and nuts, or chew them extremely well and drink plenty of fluids.

5. Routine management tips:
- Empty the pouch when it is no more than 1/3 to 1/2 full to reduce pressure on the seal.
- "Burp" gas discreetly by finding a private or down-wind spot to vent.
- After applying a new pouch, warm the flange with your hand for a minute to improve adhesion.

6. Seek professional and peer support:
- Contact local hospitals for a WOCN/ET nurse visit, even if only once; many will see patients without charge or on a sliding scale.
- Locate a United Ostomy Associations of America (UOAA) support group via www.ostomy.org; meetings often have a WOCN present and loaner supplies.

7. Mind-set and resilience:
- Remember that most people are compassionate when something happens; embarrassment fades, and accidents do not define you.
- Use rude encounters as reminders to stay kind and focus on your grandson’s joy and activities you enjoy, like going to the beach, hunting, or climbing.
- Keep in mind that the first year is the hardest; confidence builds with experience and reliable gear.