By Robert A. Winfree, Ph.D.

Read Part 1 of Robert’s advice!

I’ll admit that it’s been a steep learning curve and sometimes a bumpy ride since I became an ostomate, five years ago. But honestly, my life has never been better than it is now. I’ve picked up a lot of good suggestions along the way, some of which I’ve written about in other articles. My personal experience has been as an urostomate, but most of these 50 tips also apply to other types of ostomies. I hope that these suggestions will add to what you’ve already learned and provide some new ideas to try.

Make your home work for you 

• Add an adjustable cosmetic mirror and a light to your ostomy changing station. 

• Encase your mattress in a waterproof cover and place reusable flocked mattress protectors or disposable puppy pads under your lower sheet. Better yet, make that a double layer of fitted sheets with big pads under each, for quicker changing during the night.  Carry large disposable puppy pads with you when travelling to avoid soiling mattresses in hotels and family homes.  

• Add an extension to lengthen night drainage tubing (Figure 4). Leg bag tubing extensions will easily fit on the tapered plastic ends of most night bags (but a few require additional fittings). I lubricate the tapered barbed plastic fitting with an alcohol-based adhesive skin barrier wipe like Skin-Prep immediately before I slipping on the extension tube. (I don’t use silicone or soap based lubricants for that, as they can remain slippery.)  

• Contain your night urine drainage bag or jug in a basin at the foot of your bed and run the tubing between your legs.  That way, you can easily roll in any direction and not worry about a valve, bag, or tube leak damaging your floor coverings (it happens). Silicone medical tape is an easy and water-resistant way to hold tubing to skin and avoid potential tangles. It holds tight, but peels off easily and without residue when ready.  

• Draining the last half-pouch of urine after connecting to the night bag flushes air from the tubing and usually ensures continued drainage.  However if my urostomy pouch refills during the night, I can usually restart it simply by standing up again and straightening any tubing loops that trapped air. 

Prepare for the unexpected  

• Carry a list of your doctor’s names and phone numbers, prescriptions, allergies, and the specific ostomy appliance product numbers.  We never know when we’ll check into an unfamiliar hospital and need that information.  

• Pack and carry a pocket-size change kit whenever leaving the home, and keep extras in your jacket pockets, office and car (Figure 5). Mine fits in a folded quart zipper freezer bag. It contains a replacement appliance, hand cleaner wipe, medical adhesive remover wipes, barrier wipes, adhesive extenders (AKA banana strips), doggie-do disposal bag, and a large folded paper towel for a clean changing surface. 

• Put together an ostomy “go bag” and take it with you whenever traveling away from home, and during emergency evacuations (Figure 6). I’ve learned from experience that even regional hospitals don’t always stock ostomy supplies, so make sure your go bag contains at a few weeks to a month supply of extra pouch changes, night drainage bags, several pouch valve tubing adapters and at least one clean set of clothes. I also include at least one phone charger with a long (10’-15’) cord and earphones for down time. I can easily fit all this and more in an easy-to-carry Ostomy Explorer bag from Chameleon Ostomy. www.etsy.com/shop/ChameleonOstomy  

• Gradually build up at least a month of needed ostomy supplies to cope with lost mail order shipments, backordered supplies, travel, and the like. Stuff happens, supplies are backordered, and shipments go astray. I’ve been there. 

Experiment with new and improved supplies 

• Register right after surgery with major ostomy product suppliers (including Convatec, Hollister, and Coloplast) to receive valuable information, product samples and more. www.ostomy.org/manufacturer-information/  

• Get your best fit.  Recognize that we’re all different and our bodies change over time. The ostomy appliance that we start with may not work as well if our abdomen or stoma changes shape.  I experimented with more than a dozen appliance types before selecting the precut one-piece that I enjoy now.  Even so, I still test new product samples from time to time. Talk to an ostomy nurse or call your manufacturer for samples if you are ready to try something new.  Convex and petal-shaped appliances, stoma rings, and adhesive barrier wipes can be game changers for some of us.  www.ostomy.org/manufacturer-information/.  

• Cover your stoma and protect yourself from leaks during appliance changes with a disposable Stomagenie tube (Figure 7). They come in sizes to fit nearly any stoma. The tube’s absorbent liner and cap catch and retain body fluids for clean disposal. www.stomagenetics.com 

• I use a Sharpie permanent marker to write the day of the week that I changed on my new pouch.  I’ll generally change again three or four days later. 

• If you shave your face, you may want to shave anywhere else that will be covered by adhesives. Electric razors reduce the likelihood of nicks, but I prefer using a new disposable double-bladed razor for every shave. I keep my stoma completely covered with a Stomagenie tube to reduce any chance of nicks. I’m also careful clean my skin with a disinfectant benzalkonium chloride wipe (Hygea obstetrical wipe) before and after shaving to prevent infection.  

• Try using a hair dryer on a low setting to dry your skin and warm up the wafer before putting on a new appliance, but keep your stoma covered to avoid burns. 

• Give barrier wipes a try, even if you don’t see the need or didn’t like the ones you tried before. There’s a lot of variety in composition and effectiveness of barrier wipes, but if used correctly they all protect the skin.  Siloxane (silicone) wipes like Coloplast’s Brava are very gentle and may even extend my appliance life.  Torbot’s Skin-Tac contains a strong water-resistant adhesive. I’ve never experienced a leak when using Skin-Tac, but it requires use of Tac-Away brand wipes or other wipes that contain alcohol to safely separate the wafer from my skin later.  Rubbing alcohol packaged in a simple spray bottle is very convenient for that.  That might not work for you if your skin is irritated or generally sensitive to alcohol. 

• No-sting (alcohol-free) barrier wipes can generally be applied over ostomy powders, dried calamine lotion and Flonase spray that are sometimes applied to irritated skin. However, using barrier wipes could reduce the benefits of using ostomy products that already contain ingredients, such as ceramides, aloe, or Manuka honey to protect the skin. www.hollister.com/en/ostomycare/importanceofhealthyskin 

• Adhesive extenders (banana strips) help to support pouch weight and prevent curling of adhesive tape edges (Figure 8).  Water resistant silicone medical tape also works for this, as well as for anchoring tubing on the skin.  Products vary, but I’ve found that overlapping Coloplast’s Brava Elastic Barrier Strips XL all the way around my base-plate helps me to prevent early leaks.  

• Become familiar with different kinds of medical adhesive removers. The siloxane sprays are convenient and work well on many adhesives, but they can be expensive and hard to ship. The same solvents are contained in single-use foil packets like Hollister’s Adapt. Plain rubbing alcohol, or remover wipes that contain alcohol, work best to loosen appliances held by Skin-Tac adhesive.  

• Use an ostomy belt regularly, perhaps starting with the belt that is designed to clip onto your particular appliance.  Not only does belt pressure on the appliance help to avoid leaks due to a filling pouch, but it may also help to resist formation of a peristomal hernia.  

Disclaimer: The information shared by Ostomy Canada Society is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Every person’s ostomy experience is unique. Please consult your health care provider with any questions about your condition, care, or treatment plan.