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So this is the fourth time changing the bag, only second time on our own. I have a 20 year old girl with an ileostomy bag. This is just so confusing with products and what to do with the products, etc. A quick review, we had a home care nurse come and that didn't work out so well - she insisted on using the adapter ring with swallowed the stoma - after much freaking out we eventually got it off and replaced with a new appliance using the paste. We are on the next change and holy moly is there a serious red ring around her stoma - yikes. I do have the powder but none of the stuff your supposed to put on the powder? to prepare it? Yes, hence my confusion. As good as the hospital ostomy nurse is (and she is) she has a life and is not available on a friday at 5 p.m. Any hints on how to deal with the red ring, any products maybe we should be getting? I'm so confused and honestly don't even know when we should finally place an order for the whole kit and caboodle. Any suggestions/hints, etc. would be great appreciated
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Hi Bethie,
Learning the process and technique of appliance changes can be confusing and frustrating. It sounds as if she has a bit of skin irritation, most likely due to output getting under the wafer. Does she have an end ileostomy or a loop? I find the end ileo to be much more manageable and easier to fit because it generally sticks out a bit further than the loop. First, you really need to make sure you are measuring the stoma before putting on a new wafer. I don't know how long it's been since the surgery, but the stoma does shrink considerably over time. If the hole in the wafer is too large, stool will be in direct contact with the skin. Also, is the "adapter ring" you are referring to an eakin ring? This goes on before applying the wafer. This will give a much tighter fit, and I have found, helps considerably with skin irritation. It may seem as if it's swallowing the stoma, but if output is normal and she is not experiencing discomfort, it should be OK. In terms of the powder, the kind I use doesn't require any prep. I simply sprinkle the powder over the red, irritated areas before putting on the wafer. Maybe you have a different kind?

Does your hospital have more than one ostomy nurse? They should have gone over the ordering process for supplies with you before discharging you from the hospital. If not, do you have a post-op appointment already scheduled? I usually see my ostomy nurse in conjunction with my appointments with my surgeon. I was give a catalog, and my nurse flagged the pages of the supplies I would need. You should call the nurse if you are unsure of anything in terms of process, as they are there to help you.

Best of luck!
Bethie-Colleen is correct that the beginning is frustrating and a bit of trial and error. A good seal is very important in protecting the skin. I used the adapt rings and also found that the stoma would get a bit swallowed by them but it never blocked the output so if your daughter isn't having problems w output I wouldn't focus on that. The rings are designed to help absorb moisture which makes them puff up. I suggest you stretch the ring to the exact size of her stoma and place it on the flange first. Apply the powder around the stoma, wiping away excess and then apply the flange. After the bag is attached (if using 2 piece) hold your hand over the appliance w mild pressure to allow a nice seal. Hope this helps. Good luck

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