Marshmallows and paper towel hats: tips for anytime appliance changes

The main room of our condo during a recent vacation with Doug’s parents looked a bit like an outdoor gear store. Snowboards and skis of all sorts lined the wall and a plethora of boots sat in front of the fireplace. Closets, dressers and duffel bags overflowed with Capilene, fleece and Gore-tex clothing. During a week in the mountains near Winter Park, Colorado, we took part in two days of biathlon racing, and one day each of skate skiing, snowboarding and telemark skiing. I also managed to squeeze in some hiking and sketching in my nature journal in Rocky Mountain National Park. With so many activities on the schedule–some of which required an early start–it was hard to know when to fit in my appliance changes.

Our vacation included to days of biathlon racing.
Our vacation included two days of biathlon racing. I would rather change my appliance after dinner and face the biggest volcano of ostomy output than get up at 4 a.m. to change my appliance before a race.
I also put on my telemark skis after not using them for eight years (and then could barely walk for the next week.) I am trying to relearn this skill so I can use my tele skills to get out to some Colorado ski huts next winter. Stay tuned for a post in 2016 about changing your appliance in a communal ski hut.
I also put on my telemark skis after not using them for eight years (and then could barely walk for the next week.) I am trying to relearn this skill so I can use it to take trips to Colorado ski huts next winter. Stay tuned for a post in 2016 about changing your appliance in a communal ski hut.
Since I could barely walk after my day of telemark skiing, I opted to sit down and sketch in my nature journal for one day of the trip.
Since I could barely walk after my day of tele skiing, I opted to sit down and sketch in my nature journal for one day during the trip.
My snowboard was feeling left out, so I took it out for one day on the slopes. My legs were so tired from days of non-stop winter sports, that I completely lost the ability to make my board turn after a few runs. Note to self-- sliding down the entire front side of the Winter Park Resort on your heel edge is not much fun. Best to take a rest day instead.
My snowboard was feeling left out, so I took it out for one day on the slopes. My legs were so tired from days of non-stop winter sports, that I completely lost the ability to make my board turn after a few runs. Note to self– sliding down the entire front side of the Winter Park Resort on your heel edge is not much fun. Best to take a rest day instead.

Unfortunately, appliance changes aren’t that quick for me. Due to pretty acidic ileostomy output, I have to protect my skin with several layers of products. Stoma powder, skin prep, Duoderm, Eakin Seals and paste–I use them all. My changes usually take at least 30 minutes–sometimes longer.  Even when I use all those products, my output chomps through them like a piranha if I try to go longer than three or four days, and I end up with very raw and painful skin.

The the saying "simple is better" does not apply to my appliance changes. I need a lot of layers of products to protect my skin. Putting on all this stuff takes a lot of time and gives my stoma ample chances to expel output everywhere.
The saying “simple is better” does not apply to my appliance changes. I need a lot of layers of products to protect my skin. Putting on all this stuff takes a lot of time and gives my stoma ample chances to expel output everywhere.

Those with an ileostomy know that it can be pretty hard (if not impossible) to find even a short chunk of time when your stoma isn’t pooping. Usually I try to change my appliance in the morning as that is when my stoma is the most quiet. However, on a busy ski vacation (or any time with a full schedule) that plan doesn’t always work. If I already have to wake up at 5 a.m. to make it to a race on time or catch first tracks in powder, it is hard to get up even earlier to fit in an appliance change. Also, I don’t like worrying about when I am eating and how it will impact my appliance swap. If I want to head out to a restaurant for a post-ski meal later in the evening, I go for it even if I know it will be harder to change in the morning due to the extra output. In some cases I will even switch out appliances in the evening right after a big dinner (gulp!) if that is the best way to fit it into my schedule.

If you are wondering if I have a particularly quiet and cooperative stoma, the answer is no. My stoma is a non-stop workhorse and churns out output 24/7.  Fortunately, I have some tricks that allow me to change at any time of the day even when my stoma is active.

Trick number one: Marshmallows
My stoma nurse first let me in on this little secret. If I eat four to six regular-sized marshmallows about 15 minutes before a change, my stoma will usually stop outputting for about 30 minutes–just enough time to finish getting my appliance on.  I can’t make any promises that it will work for you, but I recommend giving it a try. It is the only time you will get to eat marshmallows for health reasons. I have no idea why the very first individual to discover this trick was dining on marshmallows right before changing their appliance, but I sure am thankful for their sweet tooth!

This photo isn't from our winter vacation but does show my love for marshmallows. They are best over a campfire, but I will happily eat them cold before a 5 a.m. appliance change.
This photo isn’t from our winter vacation but does show my love for marshmallows. They are most delicious when toasted over a campfire, but I will happily eat them cold before an early morning appliance change.

Trick number two: Make a hat for your stoma
When I first got my ostomy, I absolutely dreaded changes. They were tear-filled endeavors wrought with frustration because I couldn’t get my barrier ring and wafer on without my stoma pooping all over the place and ruining the adhesives. I turned to the internet for ideas to solve this problem and discovered a post on a forum that suggested wrapping the tip of my stoma with a strip of paper towel. I gave it a try and couldn’t believe how well it worked! Plus I liked that it made my stoma look like it was wearing a cute hat.

Four years later, and I still use this method during every single change. As my stoma chugs out stool, the little hat fills up. When it has reached maximum carrying capacity, I simply pop it off, toss it in the trash can next to me, and wrap on another. Along with collecting output, the stoma hat frees up my hands to put on powder, barrier film, and all the other products that I use to protect my parastomal skin. It also keeps the base of my stoma dry as it absorbs some of the moisture from the mucous membrane.

This little trick allows me to change whenever I need to as it doesn’t matter if my stoma releases output; the hat is always there to catch it. Occasionally, if my output is profuse and watery during a change, the technique doesn’t work as well. However it is better than nothing, and if my output is watery, sometimes gulping down a few extra marshmallows will temporarily slow down the flow until I can finish the change.

I realize that making a hat for a flush stoma won’t work very well, so this trick works best if your ostomy protrudes from your belly a bit.

The only supplies needed for a stoma hat are one-inch-wide strips of paper towel.
The only supplies needed for a stoma hat are one-inch-wide strips of paper towel.
JWilbur my stoma models a poo-catching paper towel hat. To make one, simply wind the paper towel strip around the top of our stoma and you are set to go.
My stoma, Wilbur, models a stylish poo-catching paper towel hat. To make one, simply wind the paper towel strip around the top of your stoma and you are set to go.
It is easy to slid your wafer right over the stoma when it is wearing a hat. Note that under the wafer, I have already put on my Eakin ring and other materials.
It is easy to slide your wafer right over the stoma when it is wearing a hat. Note that under the wafer, I have already put on my Eakin ring and other materials. If you are using a one-piece appliance, you can still use the hat method. Just pop the hat off right before you put your appliance over your stoma.
All pouched up with no mess at all. For those who are wondering about the tape job, I love Convatec wafers but the tape irritates my skin. I cut it off and add my own strips of Medipore tape.
All pouched up with no mess at all. For those who are wondering about the tape job, I love Convatec Durahesive wafers, but the tape irritates my skin. I cut it off and add my own strips of  3M Medipore tape. This combo adheres well through showering, swimming, and all sorts of sweat-inducing sports.

If you feel your ostomy controls your life and confines you to a certain schedule, keep searching and experimenting to find solutions. I’d never have guessed that something as simple as marshmallows and paper towel “hats” would give me the freedom to live with my ostomy on my terms rather than the whims of my stoma.

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33 thoughts on “Marshmallows and paper towel hats: tips for anytime appliance changes

    1. Pam,

      Glad to hear they help you too! Who would have ever thought such a simple thing would work. I have heard that it is the gelatin in them that slows things down, though I am not positive of that. Hmmmm…. maybe I should try gummy worms next:)

      -Heidi

  1. I have a urostomy rather than an ileostomy or colostomy so marshmallows aren’t useful, (but I enjoy them!!!). I only have to deal with urine output during appliance changes-minor by comparison.

    1. Hi Les,

      Thanks for writing! True that marshmallows won’t do much for urostomy folks other than satisfy their sweet tooth:) I don’t know much about urostomies, but it seems like it would still be tricky to change with urine outputting as it would make things very wet. With an urostomy does the flow come out non-stop or is it more intermittent allowing you to time changes?

      -Heidi

  2. Mine is very sm. use the 22 mm wafer & short, but the hat trick still helps while I’m getting the (I call them the Irish ring) opened & the protectant etc. I am able to attach the bag & wafer together & then apply on top of the Irish ring, the bag is see thru. Would like to be able to apply sep, but mashing the bags ring to the wafer, seems to be too rough. Barely managed to get it done, when I got the filter separated fr the bag when pressing a q tip around the inside to adhere the Irish ring to my skin. It says to run your finger around it after app, since its so sm. no room for a finger. I didn’t want to start fr scratch, so used another bag, but don’t want to go thru the mashing my body so hard again. How do you get all the old adhesive etc off when you are out & about? Will watch for your next post. Thanks for the tips.

    1. Have you tried hollister brand? It has a floating flange so it’s easier to clip closed with the two piece. I don’t find it sticks as well for me, but I think it’s due to the scar tissue around my stoma.

      1. Thanks I used those types very well when I had a by-pass colostomy, while they shrunk my tumor, but when they closed it off & gave me the ileostomy it didn’t work for me then. Maranatha Carla

      2. Further thoughts for Carla – how long ago was your operation? If it was in the last six months or so, sometimes giving it more time will allow you to press a two piece appliance on without it feeling rough. My other thought for your consideration is, why are you using a two piece? The benefits to me are that it is easier to pouch without the bag on, and that I can have a fresh bag without changing the wafer or even pouch out when I am in a tight spot and can’t empty. Possibly the other advantage is that the adhesive of the two piece may be a bit better, as it is designed with multi-day wear it mind. It seems to me if you are pouching it as if it were a one piece, and not able to put on a fresh bag, why use a two piece? If you can’t find a two piece to work for you at this time (see some options above), would it be just as easy and less expensive to use a one-piece? Anyone else have some thoughts on this issue?

      3. Agreed- if you are using a transparent two-piece and never separating the two-pieces… it might make sense to just switch to a transparent one-piece. The one-pieces are very low-profile which is nice. My nurse insisted that I use one-pieces in the initial few months after surgery so I didn’t have to push on my tender belly so much. The only reason I ever switched to a two-piece is so I could swap out different pouches while leaving the wafer on. I also liked that I could then use opaque bags (I was never good at getting opaque one-pieces centered around my stoma… I couldn’t see what I was doing through the plastic.)

        If you aren’t separating the two pieces much, the adhesive coupling ones Matilda mentioned are another option. Convatec and Coloplast also each make a version of an adhesive-coupling appliance. The bag attaches to the wafer with a heavy-duty adhesive (like a sticker) rather than a plastic ring. I tried both these brands and they just didn’t meet my needs because I like to swap pouches and peeling off the used ones and trying to get a fresh one to adhere to the same wafer was a pain (and messy.) However, for your situation they may work well.

        Cy-med is another pouch brand I have heard good things about that uses adhesive-coupling. http://www.cymedostomy.com/ I have not tried them however.

        Good luck!

    2. Hi Carla,

      Great to hear from you! I can totally understand what you mean about having to press down on the bag to get it to attach to the wafer. My Convatec system is horrible for that. I have to tense my stomach as much as possible and then push down like crazy to get them to snap together. Sometimes wetting the plastic rings on the wafer and pouch helps a little. Also, right when I take them out of the package, if I snap and un-snap them together a few times it seems to loosen the plastic ring a bit and then I don’t have to press quite as hard during my actual change.

      Yes- using a clear pouch definitely helps when the wafer and bag are attached together. Right after surgery, I used a clear one-piece. I never would have been able to center it over my stoma correctly if it was opaque.

      My favorite product for getting off adhesive residue is Convatec’s Adhesive Releaser Spray (and it also comes in a wipe). It is silicone-based so it leaves no residue. You don’t even need to wash it off with soap an water like the oil-based ones.

      Spray:
      http://www.convatec.com/products/skin-care/sensi-care/sensi-care-sting-free-adhesive-releaser-spray/p-609e1b05-269d-4dfb-8ca6-711554d3629b/3_0022/

      Wipes:
      http://www.convatec.com/products/skin-care/sensi-care/sensi-care-sting-free-adhesive-remover-wipe/p-609e1b05-269d-4dfb-8ca6-711554d3629b/3_0023/

      I usually use the spray to peel my wafer up and off. Then I use the wipes to get the sticky residue from the tape and the Eakin ring residue off. If I am out in the wilds, I skip bringing the spray and just use the wipes. Again, since you don’t have to wash the adhesive releaser off before you put on your wafer, it is great for changing in the wilderness when there is no access to a shower.

      Hope this helps!

      Cheers,
      Heidi

    3. Have you tried Coloplast? They use a sticker to attach the bag. It’s also flatter than the brands that use rings to attach the bag. The sticker that holds the bag is very strong and has a thin plastic that you press between your fingers to attach NOT against your body. When my out put is thick it collects in a lump over my stoma and I use my thumb to push it down frequently. My bag has never come off or had a blow out.
      Please be proactive about what system works for you and get samples form many companies. I’ve meet people who just put up with things because their nurse didn’t suggest trying a different company. I love my ostomy nurse but I’m the one that has to deal with the device 24/7.
      This is an unpaid advertisement from a non employee for COLOPLAST. 😉

  3. I like the hat idea, but I don’t think it would work with my stoma. I have opted for the get the wafer on ASAP while also trying to keep the output off my skin. I use eakin seals too. I also have very high output and find if I take a half an Imodium in the night it helps, but I have to be careful because if I eat something thickening it can pancake if it is too close to the time after the Imodium. I get four days with the Convatec when I have high output, more if I don’t. No other brand can handle that kind of output I find. Since work is so high intense I need a product that will withstand it, and these products are up for the test!

    1. Sorry to hear that the hat method won’t work for you, but it sounds like you have a good method with the Imodium. I agree with you about the Convatec wafers. I have not found any other brand that stands up to my output as well. I love Eakin rings and they are the best I have found too, but I wish they would hold up a bit better. They totally prevent leaks for me, but after three or four days the part right around my stoma is completely eroded away leaving a little sliver of skin exposed (though the part of the Eakin further out under my wafer holds up fine.) In fact, I have an itch right now next to my stoma that tells me it might be wise to change before I go to bed:)

      -Heidi

  4. To speed things up and minimise the time spent un-pouched or un-hatted, I apply the Eakin ring to the skin side of the flange and smooth the excess so it is sticking up through the hole, surrounding the opening. I then apply the flange and ring in one move, roll up a nice little collar around the stoma and snap on the bag. Heidi, have you tried brava elastic tape? You may be able to get away with using two crescents of that, rather than multiple pieces of tape to secure your wafers when you need a quicker change.

    1. That is a great idea to put the Eakin on the flange and have it extend up through the opening a bit. I will definitely give it a try!

      I have tried the Brava Elastic strips in lieu of the little 3M strips of tape. The Brava Elastic Barrier Strips still irritate my skin a little bit. It seems like no matter what– unless I use the separate pieces of 3M Medipore tape as pictured– I get little tension blisters around the outer perimeter of my wafer if my belly swells at all from water weight gain during the day, or if I bend and move a lot during sports. It is like the wafer tape can’t stretch with my skin so it pulls it right along the edge leaving blisters. I will say that this problem happens less with the Brava strips as they are a little stretchy, but I still get the irritation to some degree. That said, if I really want to have extra reinforcement, I will occasionally use the Brava strips even though they bug my skin. They are wonderfully sweat and waterproof. I actually used them on my climb of Rainier because I wanted absolute confidence that my wafer wouldn’t peel up. I would also use them if I was ever going to spend all day in the water (like if I was on a beach vacation or was spending all day at a water park) because they are so waterproof. Fortunately for most other times, putting on the little strips of 3M tape doesn’t take all that long. It is all the other stuff I have to pile under the wafer that takes up the time. Maybe your suggestion with the Eakin ring will speed things up a bit too. Thanks again!

  5. Dear Carla
    Dansac two piece appliances are easy to put together without floating quite as much as Hollister. And Welland make a couple of types that stick together, rather than click, so again no force required. I like the Q tip idea. Another option is to go to the hardware store and check out the plumbing/garden irrigation section for a piece that is the right diameter to fit around the stoma and apply pressure inside the ring to get a good seal.

    1. Hi Christine,

      I hope they help! The morning of my recent surgery, I couldn’t eat anything as I was going to go under general anesthesia in eight hours. However, I wanted to change my appliance before the surgery so that I had a fresh one on and it wouldn’t leak during the procedure (which would have been highly unlikely… but it is always best to be prepared:) Since I hadn’t eaten in a long time, my stoma was spitting out this profuse yellow liquid bile while I was changing. It would have been a total nightmare without the stoma hats!

      Cheers,
      Heidi

  6. Thanks for sharing your experience with us. You are an inspiration for the people having Ostomy and they feel as if their life has all ended. People with Ostomy may use the Ostomy Lingerie under their regular dress so as to support their Ostomy bag attached to their intestine. They are designed so as to make your life painless.

  7. When u put the hat on, where do u put the final piece of paper?
    Do you tuck it in the opening? So it dosnt unravel and fall off.
    Thanks i will try the hat tip tomorrow see it helps with my squirty gurty ha ha.

    1. Hi Michelle,

      I wrap the strip of paper towel around my stoma a few times and then fold over the top. This seems to hold the wraps together well enough. Usually my stoma is so moist that the wraps sort of stick to it anyway. My stoma fills the strips up pretty fast sometimes, so I am constantly pulling off one “hat” and wrapping on a new one. I hope the technique worked for your change!

      Cheers,
      Heidi

  8. Thanks for the tips, i just had mine done on September 10th of this year. I have a hard time finding a bag that stays on good without having a breech. I am allergic to the tape after having my surgery, plus they don’t stick that well. I have been using both comatec and comaplast non tape brands. I do security and have to were a bulletproof vest, so i get relly sweaty. Before I went back to work i could get about a week out of them. Now i only get mabey if I’m lucky 1 or 2 days out of them. It is hard to change due to the fact i work midnights. It was very active when i went to change it in the morning due to a breech. I ate 3 marshmallows and put toilet paper around it. It took almost a hour before i was able to put the new set up on. I had to stand in the tub to do it. ( easy clean up)

    Ed

    1. Hi Ed,

      I am glad the site has been helpful for you. Changing when a stoma is active is really tough. I change mine before work and I always have to get up extra early in case my stoma starts spewing uncontrollably and I have to wait it out. Marshmallows and paper towels work most of the time, but there are still those instances when even those aren’t enough!

      Sorry to hear that your wafers aren’t adhering very well. Have you by chance tried Coloplast Elastic Barrier Strips? They are a non-tape material that is meant to picture-frame your wafer and add extra security. I have been cutting the tape off of my Convatec wafers for some time now as their tape irritates my skin. (I sometimes order the tapeless ones too.). I have then been adding my own 3M Medipore Tape around my wafers to hold them down as it is hypoallergenic and doesn’t bother my skin.

      Address for the 3M Medipore Tape
      http://www.3m.com/3M/en_US/company-us/all-3m-products/~/3M-Medipore-Soft-Cloth-Surgical-Tape?N=5002385+8707795+8707798+8710678+8710845+8711017+3293321963&rt=rud

      Here is a blog post that shows my method for using the tape: https://ostomyoutdoors.com/2012/06/12/skin-sleuthing/

      However, lately I have been having great success using the Coloplast Elastic Barrier Strips instead of the 3M tape for the same purpose. In the instances when stool has started to leak under my wafer, the Coloplast Barrier Strips have kept it from completely escaping and causing a mess. They are also very sticky, so they may hold up to perspiration well. I normally change my wafers every 3-4 days, and they last that long no-problem.

      Here is a link for the Coloplast Elastic Barrier Strips:
      http://www.coloplast.us/About-us/Coloplast_Samples/Try-the-NEW-Brava-Elastic-Barrier-Strips–now-in-new-shapes/?gclid=COKP1sPms9ACFQMDaQodxNQIeA&gclsrc=aw.ds

      Coloplast will send you samples of them if you fill out the form on their website.

      I hope this helps!

      Cheers,
      Heidi

      1. I have added Brava sheets under neath my usual appliance to get extra wear time and even when it leaks, the sheet gives me extra protection so I have a lot fewer big leaks. I think the hernia belt supplied by Nuhope also helps.

      2. Matilda- I had a chance to try the Brava sheets and I love them! I don’t use, the whole sheet, but cut smaller pieces off of it to picture-frame the 1/2 inch around my stoma. I used to use Duoderm for this, but the Brava sheets work so much better to protect my skin. The material the sheets are made of absorbs stoma moisture and output really well and prevents it from irritating my skin. Thanks for sharing!

      3. Thanks for the reply back. I am using the Coloplast infant wafer as well as the locking bags and the sking barriers. I am using a new soap from Africa that helps my appliances stick better. I also use a hair dryer to warm the adhesive up before putting it on. I’m now getting anywhere from 5 to 7 days out of it, the last one i had on i probably could of gotten 10 days but i changed to shave under it

      4. Hi Ed,

        I am so happy to hear that you found something that works. Five to seven days wear time is outstanding!

        I hope things are continuing to go so well with your appliance!

        Take Care,
        Heidi

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