I've had an ileostomy for 20 years and have done quite well with my original system and methods (Smith and Nephew skin prep, Convatec Sur-Fit Stomahesive with tape, 10" open end pouch, and a mini pouch for water sports). Even with living several years in the hot and humid South and water skiing frequently, and white water kayaking canoeing elsewhere, I've never had to do anything special about skin care and adhesion when moisture was an issue except change the wafer every couple of days instead of every week.
Now I live in the dry West and bicycle a lot, often 80 - 100 miles several days in a row in substantial heat, and have run into wafer adhesion and skin breakdown (around the stoma) problems due to sweating and the motion of pedaling. I wonder if peri-menopausal chemistries have changed the character of my skin and sweat. My abdomen and pouch aren't in the way of my thighs, I pull up my jersey for better air flow since lycra isn't the most breathable fabric, and I'm diligent about changing my setup frequently, but still am having problems. I've quit using paste around the wafer opening because it seemed to be a conduit to spread my output outward between skin and wafer. I've also tried the more supple Hollister New Image Flextend system with a floating flange but adhesion might not be as good as my old system, and I've wondered if the floating flange causes too much movement and might actually contribute to the skin breakdown. On long hot rides when my skin is iffy I've had to change appliances several times during the day, using skin prep is extremely painful, and there's so much moisture already that getting the skin to dry prior to applying the new wafer is almost impossible. And what to do with all my soiled gear while riding a bicycle is logistically difficult.
The other issue is abrasion of the skin beyond the tape due to movement of the bag, especially the side of the bag. I've tried multiple tapes to protect the skin, from pink tape to Tagaderm to silk tape. The pink tape was the worst (doesn't breathe and caused a rash), Tagaderm felt good but held pockets of sweat (amazingly dripped and sprayed sweat everywhere when it was removed!), silk tape was marginally doable (at least it protected the skin), and several others were dismal failures.
My dermatologist prescribed some aluminum chloride (the active ingredient in antiperspirants) to apply under the skin prep, but I won't be able to really see what it can do until next summer. And I've consulted with an ET nurse but, other than the aluminum chloride, don't have any great ideas. I'd welcome any input from o'mates with similar experiences and hard-earned wisdom!!
Now I live in the dry West and bicycle a lot, often 80 - 100 miles several days in a row in substantial heat, and have run into wafer adhesion and skin breakdown (around the stoma) problems due to sweating and the motion of pedaling. I wonder if peri-menopausal chemistries have changed the character of my skin and sweat. My abdomen and pouch aren't in the way of my thighs, I pull up my jersey for better air flow since lycra isn't the most breathable fabric, and I'm diligent about changing my setup frequently, but still am having problems. I've quit using paste around the wafer opening because it seemed to be a conduit to spread my output outward between skin and wafer. I've also tried the more supple Hollister New Image Flextend system with a floating flange but adhesion might not be as good as my old system, and I've wondered if the floating flange causes too much movement and might actually contribute to the skin breakdown. On long hot rides when my skin is iffy I've had to change appliances several times during the day, using skin prep is extremely painful, and there's so much moisture already that getting the skin to dry prior to applying the new wafer is almost impossible. And what to do with all my soiled gear while riding a bicycle is logistically difficult.
The other issue is abrasion of the skin beyond the tape due to movement of the bag, especially the side of the bag. I've tried multiple tapes to protect the skin, from pink tape to Tagaderm to silk tape. The pink tape was the worst (doesn't breathe and caused a rash), Tagaderm felt good but held pockets of sweat (amazingly dripped and sprayed sweat everywhere when it was removed!), silk tape was marginally doable (at least it protected the skin), and several others were dismal failures.
My dermatologist prescribed some aluminum chloride (the active ingredient in antiperspirants) to apply under the skin prep, but I won't be able to really see what it can do until next summer. And I've consulted with an ET nurse but, other than the aluminum chloride, don't have any great ideas. I'd welcome any input from o'mates with similar experiences and hard-earned wisdom!!
