Seeking advice on stoma care and wound healing

After feeling lousy for 10 days, I made a doctor appointment.....I met with the doctor at 10:30 and was immediately sent to the local hospital emergency room. By then, I was in some serious pain. I had a perforated colon, and I was in critical condition. They couldn't operate for nearly 24 hours as my potassium level was dangerously low. I came out of the surgery with an open incision for 5 days, and then they closed me up and gave me a temporary colostomy. I spent many more days in the hospital, came home on 1/1/14 to start my 12 months with a stoma and bag.
I went to the colostomy nurse twice in the first two weeks after being home, but not since. I use a one-piece pouch, and I am miserable with the way the skin feels around the stoma. I have read a lot of helpful hints that I have tried on this website........but my main question is, should I see my wound care nurse on a regular basis? I see my surgeon in two weeks for my checkup; the last time I was there (a month ago) he didn't even look at my incision. Which still hurts. I'm concerned about the pain I still have when I cough.
I am so depressed over this whole traumatic experience. I know I'm lucky to be alive. I am glad that my colostomy is (probably) reversible. I have a lot to be thankful for, but I am tired of hurting after nearly three months.....surgery date 12/21/13.

Hi Ruby.  So sorry for all the crap you're going through but you seem to be handling it way better than I could.  

You mention the skin around the stoma being a problem and I'm assuming its raw, burning, excoriated or some combination.  For that and for all your discomfort you should see whomever is available as often as necessary to help you.  

Since you're using a one-piece you probably change it every day.  That could be traumatic to the skin and a WOCN should advise you accordingly.  If your skin is messed up because of contact with the discharge from your stoma, the method of application and perhaps the type of appliance might need attention.  A good ostomy nurse will recognize that immediately.  

Please get the help you deserve and keep us posted as to your progress.

Sincerely,

Mike

Thanks, Mike.

Actually, it has an opening at the bottom, so I can empty it. So, I change it every few days... usually 3 or 4 days. The soreness and pain come and go, as does the itchiness. The stoma powder really seems to help. But sometimes when I have the bag off, the skin underneath where the waxy stick-to-you stuff was is red and bleeding.

This whole thing has been a huge learning process... not thinking before I ate a bunch of raw carrots with ranch dressing... dealing with gas and the resulting balloon pouch... my little dog is fascinated with the way I smell sometimes... especially my tummy.

I see my surgeon next week and am compiling a list of questions. He is going to refer me to a specialist soon because he wants an expert to do the reversal and put me back together. I just hope I can find one that can and will operate out of my local hospital. We'll see.

Hi Ruby...a couple of quick comments... To help heal the skin under my wafer when I have to deal with minor breaks or rash-like situations, I clean first with a baby wipe (never use soap). Cover the area with an antibiotic suave. I use Polysporin TRIPLE Antibiotic Ointment, then spray with Cavilon barrier spray, and then attach the wafer (two-piece system) and tape down the edges for several hours. You might want to consider a two-part system as it might reduce the number of times you have to change the wafer...

MY last comment is most important: surgeons like to slice and dice, that's what they do, but make SURE the surgeon who does your reversal is a specialist surgeon in this procedure and has an excellent reputation...far more important than being close to home. It can vastly improve the chances of success...best of luck.

Thanks for the advice, Scotiaman.
Today I am feeling discouraged. My husband gave me a stern reality check and reminded me of how many things I am not doing that I'm supposed to be doing. Like walking 2 miles a day. I know I should, but I just don't. Trying to force myself now that spring is here. I see my surgeon next week. At least I have kept the weight off, which in my case, is a good thing. I am under 200 lbs for the first time in 20+ years. I had been on the obese side of things for years, had lost a good amount of weight several years ago, and was just fighting to keep it off. Since my surgery, I have lost 15 lbs, mostly because I don't eat well. Per my husband. And he's right, and it makes me mad when he's right and I'm just cranky.

Hi Ruby,
Tell your husband to keep things in perspective, you're still here, that's a real positive. And has he offered to walk the two miles with you?
And then there is always the female prerogative, even if he's right you don't have to agree with him.
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As far as pain and itchiness around the stoma, it could be related to the size of the opening of your flange (2 piece) or bag opening (1 piece). You might look into using a Stoma Seal, try Costa Medical. Then again, you might just request samples from any of the manufacturers. Also, look into using paste, Coloplast has a new alcohol-free paste available.
And while Scotiaman's suggestions are great, I use regular soap to clean the area around the stoma, then a saline solution followed by 3M Cavillion No Rinse skin cleaning solution.
One thing I have learned, while I loved my nurses (never had so many women come to my bedroom and asked me to take my pants off), there are very few who do have a stoma. I think they give excellent advice, but it is here where you get advice from people who live it day to day.
And you know, sometimes it just feels good to be cranky.
You can try to put some mouthwash in the bag to keep your dog away.
Good luck,

Ed