This is Part 2 of Ostomy Orientation Week – it’s all about BAGS! Changing and emptying your appliance: where and how often you change your bag, what type of bag and other stoma supplies you use, peristomal skin, how frequently you empty your bag, your emptying technique and ostomy leaks.
1. How frequently do you change your bag?
Immediately following surgery, I felt compelled to change my bag every day. I had it in my head that it was gross if I didn’t! Pretty quickly that stretched to every second day, and now I normally only change it twice a week. Obviously it depends on what I’m doing, how active I am, leaks, etc. Sometimes it’s more and sometimes it’s less than this! I think the longest I’ve gone is a week (maybe 8 days)! I have a few tricks to help extend the bag life too (more on this in another post).
How often do you change your appliance?
2. CHANGING YOUR OSTOMY APPLIANCE: Where and how do you change your bag? Standing up, laying down, sitting? Bedroom or bathroom? How long does it take?
I stand up in front of the bathroom sink, and it usually takes 5-10 minutes (as long as he’s behaving!). I get all my supplies out ready to go and sit them on the side of the sink ….
– Perfumed bin liner in the sink for all the rubbish
– Tuck a ‘bluey’ under pad protector into the front of my undies (just in case!)
– Use an adhesive remover wipe to gently ease off the barrier, carefully continuing around to the centre until the bag and seal easily come off
– Use dampened rediwipes to clean around the skin and stoma itself, and another adhesive wipe to get off the stubborner stickier bits!
– Dry off with a dry rediwipe
– Use a Cavilon no sting barrier film wipe to prep the skin and make things easier to stick
– Place a cohesive seal around the stoma as snuggly as possible
– Apply the fresh stoma bag onto the seal (I use a Dansac convex one piece), not forgetting to take off the backing plate and secure the opening!
– Warm hand and/or hairdryer to aid the adhesion
What’s your bag change routine and technique?
3. WHAT’S YOUR BAG OF CHOICE?
I was lucky to find an appliance that worked for me right away. I’ve always used the 1 piece, Dansac Novalife Convex pre-cut, in the opaque and midi size. Even though my stoma is only 25mm, I use a 30mm bag, as the 25mm only comes in a mini size at the moment which holds far less volume. I use a 20mm seal and slightly stretch, so it all still fits nice and snugly around my stoma.
I’ve never had any issues, and although I’ve ordered samples of other brands/bags, I always go back to what I know and like! I should probably branch out more, but I figure if it ain’t broke, no need to fix it! I am keen to try a 2-piece though.
Did it take you a long time to find an appliance that worked for you? Do you use a one or two-piece appliance? Favourite brand / bag?
4. What stoma supply couldn’t you live without?
Apart from all the essentials, I would definitely say my HAIRDRYER! Mine travels with me everywhere and works a treat for aiding adhesion after a fresh bag change, as well as drying off a bit after a shower. The Secuplast strips (or boomerangs as I call them) come in handy too. I don’t always use them, but often add them around the edges of my one-piece base/barrier if I’m not ready to change the bag yet. It gives me extra security and extends the wear time by a day or 2.
What supply couldn’t you manage without?
5. Where and how do you obtain your ostomy supplies? How much does it cost?
In Australia we are very fortunate to have a Stoma Appliance Scheme as part of Medicare, funded by our government. If you are a member of a stoma association within Australia, you can access stoma-related aids and appliances free of charge through this scheme. I pay a small annual fee to be a member of Ostomy NSW and I can then put in a monthly order which I collect or have posted out to me at a minimal fee. I fill in an order form, email it off and I have my supplies within the week. There is a maximum number of each item you can order per month, but the allowance is quite generous. For example, 30 bags, 30 seals, 50 adhesive remover wipes and 30 barrier wipes. We are incredibly lucky to have access to this scheme as I know some countries are not covered by their public healthcare and supplies can be very expensive. Ostomates in less developed countries even have to resort to making their own ostomy appliances or reusing them.
Where and how do you source your ostomy supplies? Are they provided free or subsidised by the government in your home country?
6. How is your Peristomal Skin?
The skin around my stoma where the bag is attached is relatively healthy, but this can be an issue and big concern for many ostomates. The important thing is to keep the skin clean and clear from any stoma output, as the acidity can cause irritation. I’ve occasionally felt a stinging and itchy sensation around the skin under my bag, and that’s when I know it’s time for an appliance change! There are many products and creams that can help if you do have irritated and sore skin, like calmoseptine.
What do you use?
7. EMPTYING YOUR BAG 🚽💩
I hope this isn’t TMI (particularly the photo), but I want to cover all aspects of ostomies, and emptying our bags is a big part of daily life 😀 I empty approx. 5-7 times a day (including at least once during the night). This will depend on the type of ostomy you have (you may wear a closed bag or irrigate?), as well as your diet, and other factors. 🚽 🚽
Technique is hard to describe! I sit on the toilet (as I would have before surgery), but with my bottom right back and kind of slanted, leaning to my left, putting most of my weight down on that side, with my right knee slightly higher (sort of on my right tip toe). This makes room in between my legs to empty into the toilet bowl. I sit a couple of pieces of toilet paper in my undies ready to wipe around the edges and inside the bag opening to clean up once it’s emptied. I normally pull my undies down too (and nearly always pee at the same time!) but for the purpose of this post, I’ve kept them up 😁
How often do you empty your bag? What’s your emptying technique?
8. LEAKS: How often do you get them? How do you deal with them?
Bag leaks are probably one of the biggest concerns and issues for ostomates. Let’s face it, nobody wants to be cleaning poo off themselves. I was so paranoid about my bag leaking for the first few months, and even though I’ve never had to cope with a major leak, I still constantly feel my bag, and touch around the edges to make sure everything is in place. I have stopped carrying around my emergency kit though! I am really lucky that in almost 3 years, I’ve only ever had a couple of leaks, and they were at home (always in bed), and I managed to catch them before they made too much of a mess. I used to get them more with my loop ileostomy, but even then they weren’t too much of an issue for me. I do remember once waking up in the middle of the night to the feel and smell of poo in the bed and having to wake my husband, get up and change my bag and the sheets at 3 o’clock in the morning. It felt awful and traumatising at the time, but I cleaned myself and got on with it. I know there are some ostomates who have ongoing problems with leaks and I am sure this must be frustrating to say the least. There are lots of reasons you might get leaks including stoma shape and size, body shape, using appliances that don’t fit properly, even the weather or season can contribute. Sometimes it’s unavoidable, but there are also lots of things you can do and products you can use to help.
How often do you get leaks? How do you cope and do you have any tips to share?