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Crohn's Disease Forum » Surgery » Stoma Subforum » Barrier breaking down constantly


06-22-2012, 09:45 PM   #1
sammies
 
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Barrier breaking down constantly

I just answered someone else's post about the barrier breaking down but now everything my stoma nurse suggested (paste, echin seal, remeasuring) is NOT working. The barrier seems to be melting. I've been using Hollister flex tend two piece for 3 years. Just called the company and asked to try some other products- they are sending. But i am sooooo frustrated. Had to run out of a yoga class this week and jumped out of bed twice before making a mess. I am on cipro and humira. Can either of these effect the barrier? What do I do now ?

Quite honestly, this is really depressing me as well. I cried an hour and a half drive yesterday.

I'm going to a concert tomorrow but insisted on driving myself in case I have to leave. I'm waking up constantly to make sure I'm not leaking. No sleep.

Thanks for any help.
06-22-2012, 10:40 PM   #2
PsychoJane
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Hmmm, maybe you could try product from another brand? I would suggest to try a flange like the coloplast sensura one or Salts Harmony duo with flex fit. Well any brand that offer flanges with that type of molding. These products are really conceived to adapt to the body movement and constantly adjust. I haven't tried the Salts one, but I've been told they are even better at adapting than the coloplast. I use the coloplast ones and I haven't had a leak in over 2 years due to their engineering. You may also want to consider trying, also from Salts, the stoma turtle-neck: Dermacol. I did not try it either... but I've heard great things about it. Maybe someone here on the forum have tried it and could confirm?

You can also try to wear a stoma-belt, it is suppose to help for certain cases. It really depends what is "wrong" with your stoma; is it that the skin is uneven, let say, when you lay on your back, is the skin around your stoma even? and when you sit, is there a fold that creates? If it's uneven and if there is a fold, the type of product mentioned above should normally help. I'm hoping that your stoma nurse would have thought about that already though. Keep in mind that they are appropriate even though you don't have any particularities of the sort. I love the line I use now for the fact I don't get leakages anymore.

As far as the barrier melting... I guess that could be possible, but I've also been on long term cipro + humira and it never caused any issue to my material.

I would suggest you to contact these company and ask for samples but I know it can takes up to forever (I usually get mine so long after that I usually forget that I even requested them). However, I don't know if you have such thing as center that sells ostomy supplies, like a supplier I guess, where you can get customer service? I know that at my center, they now have certain brand that allows them to give samples so you don't have to wait forever to get them which is great!
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Last edited by PsychoJane; 06-23-2012 at 10:18 AM.
06-23-2012, 01:02 AM   #3
Terriernut
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Changing brands is a good idea. But finding out what is causing it would be better. I have had 4 major leaks in less than 24 hours.

My stoma is changing size, and I have a huge dent to the right of my stoma. The barrier rings that used to help, dont anymore. Are you using barrier rings? Have you measured your stoma lately? Have you changed your diet to more acidic lately?

I've ordered samples (takes forever!) for other manufacturers and am waiting impatiently. I was using the coloplast sensura flex. Over a year without a single issue til this last week.
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06-23-2012, 06:56 AM   #4
2thFairy
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I use the Coloplast Sensura extended wear with Coloplast strip paste. I melt barriers very quickly too. The Coloplasty strip paste swells up when it contacts fluid rather than shrink away, so it helps to form an even better seal around the stoma.
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Last edited by 2thFairy; 06-23-2012 at 09:17 AM.
06-23-2012, 01:01 PM   #5
sammies
 
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Thank you so much for the replies and suggestions!! I will contact for those specific items and will look up Salts. Yes, have added the barrier ring. Tried it with a one piece coloplast and while it held together, lots of stool was under the ring unless than 24 hours. I did remeasuring my stoma and it varies from 7/8" to 1". I cut on the smaller side. the skin is smooth and there are no indents. I'm fortunate in that respect.

This morning I had a message and could NOT settle down. Kept worrying the barrier would break down.

So draining. Thank you again. I will try just about anything.
06-23-2012, 01:18 PM   #6
Terriernut
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Sammies, I got samples in the post this evening when I got home of the coloplast rings. They are alot thinner than the Salts. I have gone back to my normal appliance, Sensura Flex. So...I will update.

I also got samples from Convatec for their mouldable base plate. I will try that on Thursday. Lets keep notes for each other, and everyone else on here.

I am also going to order the new Salts 'Dermacol' stoma collar. Fingers and toes crossed we can both get sorted out!
06-23-2012, 01:31 PM   #7
DMac
 
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[Terriernut]
I am also going to order the new Salts 'Dermacol' stoma collar. Fingers and toes crossed we can both get sorted out!
For me personally, the Dermacol stoma collars are the best product I have used in the almost 13 yrs I have had a stoma. I have never had a leak, from the side, whilst using them and I have been using them for quite a while now. I highly recommend the product.

I also use a product called HydroFrame Flange Extender (prodcut code is WAF H33, made by CliniMed) These are very flexible banana shaped sticky thingies, that you apply around the edge of the flange. Again, I cannot recommend thes highly enough. They are actually more sticky when you are either quite hot, for whatever reasons or when they get wet. They're are an absolute godsend for me personally.

Sammies, I would highly recommend you try both. All the best : )
06-23-2012, 10:49 PM   #8
sammies
 
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Are Salts products available in the US? The collar looks like just what I need. Ordered some samples from coloplast.

Almost 24 hours with eakin seal, allkare barrier wipe, and hollister 2 piece. Will I make it through to the morning?

Kept checking my shirt all the way through the concert tonight. Improved my mood that i did not have to leave early or change the appliance in a port-o-let.
06-24-2012, 01:03 AM   #9
Terriernut
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I tried the coloplast ring last night, the thinner one seems to be working.

I am not sure that Salts is available in the USA. If you have a stoma nurse, she would know what to get like it over there I would think? (I would HOPE)
06-24-2012, 01:18 PM   #10
sammies
 
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Help. Ok the eakin seal lasted about 48 hours. That's an improvement . . . What am I doing wong? The stool had gathered under the seal and worked out of the barrier. The stoma is sometimes "sticking out" a nice inch and at other times contracting almost flat.

So I just put down a layer of adapt paste and rolled up 1/2 a moldable strip on top of it. But I feel like I'm creating another layer for the atom to get through while trying to stick better.

Again I have no indentation, the skin is healthy. I did gain 10 lbs since March but this seems so extreme.
06-24-2012, 03:16 PM   #11
Terriernut
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You are having the exact same problem I am! Stoma out...stoma in. Mine is also larger than he was a week ago. Everything is going under the barrier ring and causing blowouts.

I tried the thinner seal and so far so good. (just 24 hours now) And I've also wrapped myself in Tegaderm. (flange looks like a mummy! )

I have an excuse for this...parastomal hernia. I got the coloplast flanges to try. They are mouldable to the stoma, and hopefully I wont need a barrier ring. Will let you know how I get on.

You arent doing anything WRONG! Have you rung your stoma nurse by the way?
06-25-2012, 01:32 AM   #12
PsychoJane
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The only thing I've been told to do with flat stoma is to use convex barrier and/or stoma belt. I think that might be what you are gonna try(the convex) Misty but I ain't sure. Here's what it says on the website: "The convex shape provides a light inward pressure on the area around the stoma. This helps to push the stoma outwards, reducing the risk of leakage.". From the picture it seems to be pretty logical. I've been told that I might have to use that further in time with my new stoma as it does not protude a lot. I think you both might want to consider that type of product:

-Coloplast:
http://www.coloplast.com/products/os...uraconvexlight

-Hollister:
http://www.hollister.com/anz/ostomy/...dfeatures.html

-Convatec:http://www.convatec.ca/enca/cvtca-pr...&prodfamily=59


-Salts:
http://www.saltsstomacare.co.uk/prod...supersoft.aspx

-Dansac:
http://www.dansac.co.uk/default.asp?...tails&Item=196

I was not aware there were such things as convex or non convex flange as I had been hooked with one system and was ok with it but yeah, the stoma nurse told me about those. Did she ever mentioned them to you? I guess you might have already tried these appliance but if not it might worth giving them a try as they seem to be really appropriate for your condition.
06-25-2012, 02:47 AM   #13
DMac
 
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I have always used bags that are convex. They do seem to be more resistant to leakage. This is why sites like this are so valuable. Many of us would have no idea about certain products, without someone mentioning them to us. Nurses and specialists in hospitals do not always, for a number of reasons, tell us about a wide range of products.

So we can be in a situation whereby we're struggling to cope and all it takes is for someone to mention a specific product and the problem can be solved.
06-25-2012, 07:56 AM   #14
Susan2
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[QUOTE=sammies;465323... The stoma is sometimes "sticking out" a nice inch and at other times contracting almost flat.
[/QUOTE]

My stoma is like this, too, and, after various trials, I now always use only a deep convexity Coloplast Alterna bag. (I have an ileostomy.)
06-27-2012, 02:36 PM   #15
sammies
 
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Well I tried my regular hollister 2 piece new image with no skin prep but with the mold able strip paste and a thin layer of adapt paste. That worked well and lasted 48 hours-- I really felt like it was leaking and changed it it it wasn't! Ugh!

Next up was the regular hollister 2 piece with a convex barrier rings as rec'd by the rep. 48 hours later and I could feel liquid getting under. It wasnt a full fledge leak but it wouldve been soon. The convex barrier didn't do much---still looked like my stoma was staying low and not coming up.

Now I am trying a 1 piece hollister with a barrier ring As rec'd by my stoma nurse.

Just got convatec sur- fit mold able durahesive mold able barrier and pouch. Will try that next.

Question: should I try an eakin seal with the sur fit mold able as well?
06-27-2012, 02:39 PM   #16
Terriernut
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I would steer away from Hollister. Just for now. I think maybe you need a really thin ring if any right now???
06-27-2012, 05:39 PM   #17
sammies
 
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yup hollister is off the list. Blew right though 1 piece with thin ring during yoga. Ran to my car, got my supplies--we're not supposed to bring our personal stuff in and usually this isn't a problem-- changed to a one piece coloplast that I used to use. Must not have waited long enough to let it stick. Leaked again. Had to leave and drive home. So depressed. put on the mold able sur fit and hope it works. I've got to go buy supplies--out of my own pocket now bc I just got my monthly delivery 2 weeks ago-- before we leave for 8 days in Nashville.

So so so discouraged. Thanks for listening.
06-27-2012, 06:19 PM   #18
Samboi
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I'm not sure if this will help you Sammies.
I recently changed over to little Eakin slim barrier rings.
I stick it on the base plate and then role it up, making a little turtle neck collar.
When I stick my base plate on, it has a nice snug fit.
I push down on the centre bit to make sure it sticks well too.
It's worked really well for me.
Hope you find an answer to your issue.
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07-10-2012, 10:28 PM   #19
sammies
 
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Wanted to share the products I've tried so far:

The Convatec Sur fit moldable has been working great! No leaks. However, the filter has leaked a bit on me twice and I don't like the feel of the tape or the white plasticy pouch. Probably will get a pouch cover. But I'm on my third wafer and each one has lasted 3-5 days. Much improvement for me.

I tried my Hollister 15603 one last time with an adapt ring-- great success! Lasted 4 days and I probably could have pushed it but I was getting nervous.
I agree with folks saying I should get away from hollister but I'm hoping I can alternate appliances and keep my skin happy. I'm to try the hollister moldable next.

Next to try is coloplast 2 piece with their barrier rings.

The crazy thing is I'm trying these while traveling. For the first time I years, I'm well enough to travel most of the summer but planes, strange hotels, conferences, and workshops are not great places for barrier break downs and trying new appliances. More than a bit stressful.

Thanks again for all the help.
07-10-2012, 11:03 PM   #20
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I have the same type of stomach...out...In....out. Etc... I, like 2th, use the Coloplast Sensura Click with light convexity along with the 2inch moldable ring (Adapt ring by Hollister, found it more durable than the Coloplast one) and then I put just a thin layer of stomahesive paste (Convatec) on the ring.....then slap 'er on. I then lie down flat with a hot hot water bottle for 10-15 mind to get everything adhered and molded, let. My tummy cool down for another 5 mind then I'm good to go for 5-6 days. As you can see my product loyalty is lacking...lol. I have tried a LOT of stuff and this combo really works for me. Oh and for swimming I just tried the salts ring on top and it worked great....

Good luck
07-28-2012, 10:19 AM   #21
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Interesting replies. I found that the salts flange really did not work for me. I was lucky to last more than a day with those things, they never stuck to my skin. I'm using the Hollister convex, it's a special flange for sports, smaller than the regular one but very sticky with the ring and quite good. I would not recommend the salts!
07-28-2012, 10:24 AM   #22
Terriernut
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I've had to give up on the Salts rings now myself. I've tried and love the convetec brava rings instead. They are thinner, and cause me less blowouts.
07-28-2012, 10:05 PM   #23
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I must be talking about something different because the salts cover I used was basically just like opsite ( the stuff they use over your IV Site in the hospital.....clearalmost non-existent stretchy tape), definately NOT anywhere near as thick as the Brava rings. I too just tried the Brava rings and they are really great.

Ahh blow-outs......sooo awesome,

Katt
07-29-2012, 02:14 AM   #24
Terriernut
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Katt, Salts has a 4mm barrier ring. (Not the cover) I did well on Salts barrier rings for over a year, but not anymore.

The coloplast one is 2mm and my skin likes it better too.

Last edited by Terriernut; 07-29-2012 at 09:23 AM.
07-29-2012, 05:29 AM   #25
sammies
 
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Trying the coloplast sensura two piece flat face plate with brava ring. So far, convatec sur fit is best for me--had two break downs but not til 5th day. Don't like the pouches--fiter leaks on second day, they are white/plastic/old fashioned, and I feel like I can see the stool thought them more than the beige. But, so far, this is my go to wafer. Going to try the coloplast sensura click with brava ring next.

Really helpful to get updates. Thanks for sharing.
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