Offering Encouragement and Support for all Ostomates

Category: Skin

New wafer tips

I attended the UOAA National Conference last week and got some great new information. I’ll be sharing it for weeks.  If you get the chance to go to the next one in 2019 in Philadelphia (they only occur every two years) I recommend you start planning now.

One of the recurring sessions is the Barrier Cooking Show hosted by Hollister. It’s a hands-on lab where you actually get to make a wafer! The chemist that taught the class had a couple of really good wafer tips that I hadn’t thought of:

–Before putting your wafer on, gently heat it first.  He recommended simply placing the wafer under your armpit while prepping your skin. The ingredients in the wafers become much more sticky when warm, and you’ll find adhesion is much improved if you warm it first. He said you could briefly warm it with a hair dryer (not too long!), but don’t ever put it in the microwave.  It will quickly explode!

–The other tip was caution if your bathroom tends to steam up a lot when you take a shower. If you have your supplies ready and waiting, the steam can seriously effect your wafer adhesion. He recommended actually keeping your wafer in another room, or an area where steam won’t compromise it.

I’m now paying attention to both of these and can say I see a definite improvement in immediate adhesion after heating my wafer under my armpit before putting it on. My next post will talk about the amazing Stoma Clinic hosted by the conference.  Experienced WOCNs evaluating your stoma with advice and suggestions for a multiple of appliances.  So much to learn!


That Darn Adhesive!

Like many ostomates, I’ve struggled with trying to find the right adhesive remover for me. I’ve found that as much as I like the Convatec wafers, they leave quite a bit of residue behind that needs extra care to remove. The Hollister Cera-plus wafers are much better for me, but I’ve had to adapt for those, too. What helps for me is when I’m taking a shower on wafer-changing days, I lift the edge of my wafer and literally wash underneath it. Usually the main portion of the wafer around my stoma will continue to stay stuck and not fall off. I use soap on the skin that’s exposed under the lifted outer-edge of the wafer and wash it off under the shower.  I can often feel the adhesive come off and it feels so good to feel the clean skin after.

After my shower, I follow up with the Smith and Nelson Remover Wipes around my stoma, and the Sensi-Care Adhesive Releaser to release the wafer completely from my stoma (remember, I have a retracted stoma, so my convex wafer won’t often just pull off). I’ve tried several remover wipes, but just love the Smith and Nelson brand because they are quite wet, yet clean off easily with a damp cloth and dry with no residue. The Sensi-Care releaser is, in my opinion, the best on the market for spraying the main portion of your wafer — using it makes your wafer just fall off. I also use either one of these to clean my fingers after using my sticky barrier wipe.

There are many types of adhesive removers on the market, so another one may work better for you. Also, I believe men would have greater needs, due to the the challenge of extra hair growth around their stomas. A good place to get reviews is from Eric at Eric has done an incredible job of reviewing a variety of products and I rely on his reviews before purchasing anything new.

Managing a retracted stoma

I have an ileostomy with a retracted stoma. It retracted within a couple of weeks after my surgery. Although I have some suspicions about why this occurred, I don’t really know for sure. I understand that sometimes it just happens.  Mine is not as bad as it could be — my stoma is right at skin level, so I’m able to wear a convex wafer with virtually no problems. However, I’ve gained 10 lbs since surgery and that has caused a dip on one side, so I now usually wear a ring to help fill that gap (I sometimes will use paste, but I find it very messy).

Because of the wafer convexity, and now the additional pressure applied by the ring, I pay close attention to the skin directly around my stoma. Being older, my skin is dryer and less flexible, and I want to make sure I avoid any pressure sores.  I usually wear a Hollister Cera-plus convex wafer, but every couple of months I’ll switch to a Convatec Natura convex wafer. The convexity is different between them, and it gives my skin a chance to recover a little bit. I like both of them, and they both work really well, but I’ve developed a sensitivity to the Convatec adhesive and can only wear them for a max of two changes before my skin just erupts and starts itching like crazy. I think this is a problem unique to me, so if you try this approach you will probably not have any problems.

Having a retracted stoma can be problematic, but with the right accessories it can be managed successfully.  Of course, losing the 10 lbs might help to solve some of this problem, and I’m working on that!

Summer Skin problems

Last summer I developed a horrible rash under the adhesive of my wafer. My first thought was yeast and I called my primary care doc. She prescribed three days of Diflucan, which did absolutely nothing.  I then called my dermatologist, who prescribed another four days of Diflucan. Still, no difference. By reading other’s experience with this, I now realize that yeast and adhesive reactions are a troubling and persistent problem for many ostomates. Here is my journey and solutions:

First started with Desonex powder. I would apply it all over the rash area, gently pat it in, and then gently use a barrier wipe on it before applying my wafer. I did this for several weeks with no real effect.

Then I tried a product called Zeabsorb AF, also over the counter.  This is a clay-based anti-fungal, and I followed the same techniques as with the Desonex. I also changed from Convatec to Hollister wafers because the Hollister wafers aren’t as large, and I could then rub some of the Zeabsorb AF around the edges of the wafer in-between changes.  This did seem to make a small difference.

My next experiment was with Lotrimin.  This is an OTC anti-fungal cream. I was hesitant to use this under my wafer, so I continued to use the Zeabsorb and would rub a thin film of the Lotrimin around the outside edge a couple of times a day. This worked much better, but didn’t completely clear it up. And for a short period of time I started developing leaks, and switched back to the Convatec wafers to better heal my skin. The rash then really flared up, so I knew then that this was also a reaction to the Convatec wafer adhesive.

I read an article in the Phoenix magazine about using Monostat cream. This is a cream that lots of women are familiar with for vaginal yeast infections, but I must admit I’d not thought to use it on my skin. It can be purchased OTC in a 4% concentration, which is almost prescription strength (I got mine at Walgreens). I applied a VERY thin film under my wafer on clean, dry skin and dried it with a hair dryer, then applied it around the edges in-between wafer changes. And it worked really well! Within just a couple of days I could see a big difference. There’s almost no trace of that rash now and the itching is gone.

The Monostat cream isn’t cheap. I bought generic and it was $20. I was unable to get the cream alone, so had to buy the package with the applicators, as well.  But I just threw them away and kept the cream tube.

In conclusion, I now believe that yes, I probably had a small yeast infection, but it was made worse by my reaction to the Convatec adhesive (which is a shame, because I think the Convatec products are really great).

It’s now April, almost 9 months later, and only now is my skin almost completely healed. I use almost always Hollister wafers now, but switch to Convatec for 2-3 changes every couple of months. Because my stoma is retracted, and I use a convex wafer, I do this to change the pressure around my stoma and give my skin a chance to recover. But I can only use the Convatec wafers a short time before my skin reacts to them. My current regimen is using a VERY thin film of Cortisone-10 on clean, dry skin, dry with a hair dryer, then pat the Zabsorb AF on top of that and seal gently with a barrier wipe. The Corisone-10 does a good job of keeping the itching at bay, but the secret is to keep the film exceptionally thin and make sure it’s all completely dry before applying your wafer.

This is a long post, but I wanted to let you know my attempts at this vexing problem. Hope these suggestions help you with any Summer yeast or adhesive reaction issues.

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