The A to Z Of Stoma Products

When you first get an ostomy, the world of products available can be a very disorientating and intimidating place. Do I need a ring? What is a flange? I decided to put together a glossary type guide to let you know what everything is, and what may be available that could solve a problem you are having.

ADHESIVE REMOVER SPRAY/WIPES

This is one of the products your stoma nurse should introduce you to. Adhesive remover will help you remove your bag with minimal pulling which should help protect your skin. Most companies offer their own versions of this and you can get it in spray or wipe form.

I find the spray better for removing my bag, but then use an adhesive remover wipe to get rid of the sticky residue left on my skin.

BAGS/POUCHES

Probably the most obvious product you will need! But whats with all the options? Here is a brief description of the different stoma bags which you can use, which are also called pouches.

  • DRAINABLE or CLOSED – This describes the opening at the bottom of the pouch (or lack of one). As a general rule if you have an ileotomy, you will use a drainable or one piece bag. This is because your output is higher and more liquid. The bottom of the bag will unfold and open for you to empty the contents into the toilet. A closed bag is part of a two piece system and is usually used by people with a colostomy. as they have thicker, less frequent output. The bag comes in two pieces. You attach the base-plate to your skin around your stoma and the bag clicks onto this. When the bag is full you take it off the base-plate and pop on a new one.
  • CONVEX, CONCAVE or FLAT? – Everyone will generally start with a flat bag, and you should only try a convex or concave bag under direction of your stoma nurse. Convex bags can help with stomas which are flat/flush to the skin or retracted and also if you have uneven skin around your stoma. The concave bags are new and available from Coloplast. They are designed to help fit better over hernias and curves.

BARRIER RINGS

Barrier rings can also provide a level of convexity, helping with low profile stomas. They can help fill uneven skin and scar areas around the stoma to prevent leaks and protect the skin. Barrier rings are often available in round and oval shapes and can be moulded to fit any size and shape of stoma. They can be applied directly to the skin before you place your bag on, or onto the bag itself before you put it on.

BARRIER SPRAY/WIPES/CREAM/SPONGE APPLICATORS

Another product your stoma nurse should automatically provide you with. Barrier products should be applied after you have cleaned and dried your skin and then allowed to dry before putting on your bag. They not only help protect your skin but will help it heal if it does become sore. There are lots of different options out there and different ones work for different people. It is basically trial and error to find which product and in which form it best protects your skin.

COMPANIES

There are so many companies out there offering a whole range of products. What works for one will not work for all so having such a vast choice is great but can be a little overwhelming. Here are as many of the ostomy companies I could think of and links to their websites for you to explore their products and services. Many have stoma nurses and product specialists on hand to talk to you should you require advice and can send out samples so you can try out products before adding them to your prescription.

DELIVERY COMPANIES

Again, there are a large number of delivery companies and your stoma nurse will allocate you one and help you place your first order. You may be contacted by others and can change if you wish but don’t feel pressured to if you are happy with the service you are getting.

DRY WIPES

These are usually a complimentary item offered by the delivery companies. They are used for drying around your stoma to help make sure it is completely dry before applying a new bag.

FILTER

The filter is part of the ostomy bag. It is designed to help with the build up gas produced by your ostomy, so your bag doesn’t ‘balloon’. Some work better than others!

Osto EZ Vent

Respond also offer the EZ Vent which is an air release device designed to be used with any brand of bag. Stephie over at Colitis To Ostomy reviewed the Osto EZ vent here

WEDGES

Peak Medical

An alternative to rings and pastes, these can be used to fill creases and folds in the skin around the stoma, where leaks may occur. They can be stacked until the desired depth is achieved. Also an alternative for providing convexity.

FLANGE/BASEPLATE EXTENDERS

The baseplate or flange (I personally hate that word!) is the sticky part of the bag that adheres to your skin around the stoma. Some are oval, some round and some petal shaped, designed to better move with your body. Some also contain things like Vitamin E, designed to help people with sore skin. You can cut your baSeplate to fit your stoma yourself, or ask your delivery company to pre-cut them for you before they deliver them. Ask your stoma nurse to help you measure your stoma correctly before telling them what size you need them cutting to.

Extenders are strips you can place around your bag (usually in two or three pieces) to give you some added security. I use them if the edges of my baseplate sticks up a bit (otherwise I pick and then hate it when it gets fluff from my clothes on. I also use stronger ones when going to the gym or swimming for example.

Check out my review – Stripping Down Baseplate Extenders – Worth The Hype?

GELLING AGENTS

Gelling agents can be popped into your bag when you have very loose, liquid output. They help[ thicken the output into a gel like substance, controlling the consistency withouyt needinbg to make dietary changes. Some also claim to help control odour aswell.

HIGH OUTPUT BAGS

These bags are designed for people with extremely high, pure liquid output. They will ned to be ordered by your stoma nurse if you are struggling with this. They are larger in size and have a soft tap on the bottom which can be connected to a collection device.

LUBRICATION

Pancaking occurs when a vacuum happens in the stoma bag and the output can not drop into the bottom of the bag. Output will collect at the top of the bag, potentially blocking the filter, causing soreness and pushing off the bag causing a leak. Lubrication products help the output slide down to the bottom of the bag, especially good for when your output is thicker. Some also claim to aid with odour.

ODOUR ELIMINATORS

Odour can be one of the biggest concerns for ostomates and there are lots of products available on prescription and to purchase to help control this. Some work better than others, but different things work for different people so give everything a try and see what you prefer.

Check out my post – Stinky Stanley – Coping With Smelly Output

OSTOMY BELT

Ostomy belts work with convex bag systems and help pull these further into the abdomen. This increases the tension and helps prevent leaks. They can be especially useful at night time with frequent rolling and movement in bed.

PROTECTIVE SHEETS

The Brava Protective Sheet is designed to be an extra protective layer under the base plate. It is skin friendly and also helps provide a smooth surface to apply the bag to. They are available in three different sizes.

See a video on how to use them here

SAMPLES

You can test out most items offered by a company by requesting a sample. This is a great way of seeing whether a product suits you before adding it to our prescription. You can call a company to request samples and some may be requested online.

STOMA COLLAR

Collars are suitable for all round shaped stomas and help give a stoma more shape and direction, resulting in a better spout. This will help prevent output from coming onto contact with the skin and heading straight into the bag.

STOMA PASTE

Stoma paste is used to fill gaps and creases in the skin around the stoma. It helps provide an even surface to adhere your bag to, helping get a better seal and preventing leaks.

STOMA GUARD

A stoma guard helps protect your stoma and can be held in place by form fitting clothing or a belt.

SUPPORT WEAR

You can get some support wear on prescription and some you can purchase. They can be used daily but are especially good for if you exercise and use the gym for example, as your stomach will need more support with an ostomy following surgery. Always consult with your stoma nurse/surgeon before returning to any exercise regime to make sure you do not increase your risk of hernias and other issues. They can advise on how to gently get back into workouts. Some companies that offer support wear include

UROSTOMY NIGHT BAG

A night drainage bag is available for urostomates to help them get an undisturbed and restful nights sleep. The bags are attached to the urostomy pouch and collect the urine while you sleep.

Find out more about urostomies over at Rocking 2 Stomas

WET WIPES

Another complimentary item provided by stoma delivery companies. These are fragrance and nasties free, so you can clean the stoma and surrounding skin when doing a bag change.

I hope this has been really helpful in explaining some of the products and services available. It will not be an exhaustive list, although I have added as much as I can. Please let me know in the comments if you know anymore! This is also a UK list (although some of the companies are active in other countries) as a worldwide one would just be MILES long! Hope you all have a fantastic week,

Ordering Stoma Supplies

I recently saw a post on Facebook with a lady saying she had finally got around to sorting and organising her stoma supplies.  Unfortunately, it wasn’t the  tidiness that caught my eye – but the sheer amount of products she had stockpiled.  Me and Ste both have ostomies and have nowhere near that amount and I thought I would address why and how we manage our supplies in this post.

My Delivery Company – Bullen

I get my stoma supplies delivered from Bullen.  I have previously written a review on them so won’t go on too much, but find them fantastic!  You can check out my review here

Bullen call me every month so I can place an order.  Sometimes I ask for an extra 2-4 weeks till I order if I have plenty of stock.  They are brilliant and don’t ever forget to call which means I don’t run out.  This definitely takes the pressure off me trying to remember, which is good as I have a memory like a sieve!

How Often and What I Order

So I place an order roughly every 1-2 months.  I normally get two boxes of bags – I use Salts Confidence BE bags and order whichever two colours I am short of.  I change my bag almost every day and get thirty in a box.  I will then order three packs of wet and three packs of dry wipes which are supplied by Bullen.  I get two or three (depending on my stock) each of adhesive remover spray and barrier spray.  I use the Salts adhesive remover and the Trio barrier spray.  I also order a box of the Trio adhesive remover wipes as find this is good to remove any sticky residue when I take off my bag,.  I will also order two or three packs of the Trio baseplate extenders.  There are twenty in a packet so there are ten uses in each as you use two.  I don’t use these every day and so order as and when needed.  I also occasionally use the Brava ostomy powder but I literally only need to get one every siz months roughly as they last ages!  That was one of the things that stood out to me in the Facebook post I mentioned at the start of this post – the lady had about 15 bottles of this which would take years to use, even if you use it every day!  I also get a pack of disposable rubbish bags from Bullens.

I am very grateful for the NHS who supply my ostomy products and feel this system should not be abused.  Over ordering happens so often in the ostomy community and it is something ostomates need to be aware of.  With so many cuts happening we need to ensuyre that this can stay in place, so ordering just the items we need is very important.  I always suggest having a little spare stock, just in case your delivery is delayed for a little while which could be due to a number of reasons (holiday, snowy weather, prescription issues etc).  But please don’t be stockpiling years worth of products – so much can change including the products we use and I hate to see things going to waste.

OstoBuddy App

The OstoBuddy app is an app designed for ostomates to help them monitor their ostomy and supplies.

Check out the OstoBuddy website for links to download on Apple App Store and Google Play

There are sections in the app to document your supplies so you can keep track of the stock you have.  You can enter when you have used products so it is easy to see when you need to re-order and what you need to re-order.  You can also track your output and remind yourself of when you last did a bag change.

It’s so good and helps remind me when I need to change my bag and how many I’ve left.  You can add photos to it to track your skin if it is sore.  You can write down little notes on it too.  The new version that is out now lets you track your output, it’s consistency and the amount.  My memory is awful and this app is amazing and helps me remember when it is time to change my bag, how many bags I have left and when it’s time to order.

Lisa

This is definitely worth a try if you struggle to keep track of your stock and it is free to download.  

Christmas Order Date

Last but not least I wanted to share the final dates to order your stoma supplies to guarantee delivery before Christmas.

Trio Ostomy Care – Wednesday 19th December (UK only)

Coloplast Charter – Friday 7th December

CliniMed & SecuriCare – Friday 14th December

Medilink – Friday 14th December

Bullen – Wednesday 12th December (stoma producst/medication orders) and Monday 17th December (stoma products only)

Respond – Monday 17th December

Pelican – – Wednesday 19th December

I hope this has been helpful and gives you an idea of how to go about ordering your supplies. Please feel free to message or comment if you would like help with anything I have mentioned above and don’t forget to get your Christmas orders in ASAP!

BlogMas Day Eight – Unboxing Stoma Supplies (video)

So thought I would mix it up a little bit and make a video instead of a written post for you all!  The link is

And I hope you all enjoy it!  Don’t forget to subscribe to my YouTube channel to see more videos from me and please feel free to ask any questions in the comments or by messaging the page

Happy Friday to you all xx

Getting Ste’s ‘Tea’ Ready

Good evening, this is a bit of a late one but have finally had the last day of school today and we are officially on Summer break! Yay!

Some of you may know my boyfriend Ste, know that he also has Crohns Disease and know that he has jejunostomy feeding tube (PEG-J), for some this will be new information! He had surgery in January to create an opening and a tube was pushed through his abdomen into his jejunum (the middle part of the small intestine). A section of tube remains on the outside of his body which he tapes up to prevent it dangling when not in use.

FB_IMG_1501101882689.jpg

He uses this tube daily, both for medication and for enteral nutrition. The decision was made to place the PEG-J due to his malabsorption issues and the fact he can’t tolerate food and vomits almost everything he eats due to gastroporisis. He is actually sick without even eating too. He was on at home TPN on and off for 3 years but this led to eight bouts of sepsis in twelve months. He was then taken off this for his own safety.

Ste takes some of his medication orally in soluble form as they are absorbed better by his body this way. Any other tablets he has to dissolve in St Marks solution and inject into his tube to ensure he is absorbing as much of them as possible. It also cuts the risk of him vomiting them back up.

He is also fed through the tube. This means he gets the calories and nutrients etc he needs without having to physically eat. He sometimes fancies something and will eat a little, but this generally ends up with him repeatedly vomiting. This obviously isn’t pleasant at all as this already happens multiple times a day anyway due to his gastroporisis.

The feed is delivered monthly much like our stoma supplies. He sees his tube nurse regularly who keeps an eye on the tube aswell as making sure he is getting what he needs as she is able to amend the feed he has if need be. During his last appointment she has recommended changing his feed so he is taking more calories on but he won’t start this until he receives his next delivery.

Ste taught me to be able to set up his feed and now I often get it ready for him while he is in the shower or changing his stoma bag before bed. I thought I would take a few photos and try and briefly explain this so people have a little better of understanding of what comes with having a feeding tube.

For these purposes I’m setting him up a one litre feed (easier to describe and photograph), although he normally has one and a half litres which we have to make up into a larger bag along with 17.5g protein powder. First I get together the things I need which includes his pump and stand (this is left to charge during the day while not in use), the bag of feed and the giving set.

Next up I take off the cap at the feed bag end of the tube and the top of the bag of feed. Then you have to screw the tube into the bag of feed before turning it upside down and hoping you got it in tight enough! I then pop the bag of feed into the stand and strap it in place.

The next part of the tube runs through the pump and then back out again.

I have now got the rest of the tube gathered up ready and I turn the pump on. Now I need to fill the tube up so it is ready for Ste to attach to his PEG-J tube so I press the fill set button.

The tube fills, and fills, and fills, and stops just short of the end! I press the fill set button again until the liquid is right at the end of the tube before pressing it again to stop it.

 

IMG_20170726_211631.jpg

It’s now ready for Ste to screw into his JEJ tube and he will start the feed off. A one litre bag will take approximately 12.5 hours to run through for Ste as he has it on around 80ml/hr. Some people can tolerate it at speeds of up to 125ml/hr so their’s will only take around 10 hours. Ste has it running overnight to try and minimise the interruption to his daily life. If he gets up in the night he has to carry the stand with him to the bathroom as he is constantly attached to it while it is running.

The tube can be left in indefinitely. The tube part may need to be replaced at some point but as the major surgery work has been done this wouldn’t be a huge undertaking. The site of the opening needs to be kept clean and he has to advance and rotate the tube weekly. This means he has to push the tube about an inch further into his jejunum and rotate it around 360 degrees. This minimises the risk of scar tissue building up and ‘burying’ the tube which could cause issues and lead to further surgery.

I hope this has been an interesting insight into life as a tubie, particularly a PEG-J which isn’t used nearly as much as other types of feeding tubes such as NG’s (nasogastric) or PEG’s (percutaneous endoscopic gastrostomy).

Please feel free to ask any questions or share your experiences of feeding tubes below. Ste is also happy for me to pass on questions to him and will reply in the comments.